- Synovial Osteochondromatosis
- Synovial Lipomatosis (Hoffa’s Disease)
- Pigmented Villonodular Synovitis (PVNS)
This is a benign tumorous proliferation where joint synovium (In lining of the joint) produces multiple cartilaginous and chondro-osseous loose bodies.
Swelling, pain, limitation of motion, clicking and at time locking of the joint is the most frequent symptoms. These loose bodies may be from few to few hundred and varies in size.
Radiography is the most common method of diagnosis providing the loose bodies or calcified/ossified and magnetic Resonance Imaging (MRI) will identify those that have yet to be calcified/ossified.
In case of few loose bodies arthroscopic surgery is usually the treatment of choice. However, in cases where recurrent has taken place and or there are large number of loose bodies with potential for recurrence then an open surgery and removal of the entire knee lining (total synovectomy) may become necessary.
In rare instances there may be malignant transformation.
Synovial Lipomatosis (Hoffa’s Disease)In this condition there is enlargement of the fat pad behind and on both side of the patellar tendon. Symptoms: This condition may result pain and aching sensation in front and around the patellar tendon and can be aggravated by physical activities and sport. There will also be swelling which may fluctuate depending on level of activity and duration of rest in between. Diagnosis: A careful clinical examination and if necessary, an arthroscopic examination and biopsy will confirm the diagnosis. Treatment: Excision of a part or most of the fat pad usually eliminates the symptoms. This can be accomplished by arthroscopic technique with quick recovery and return to activity and sport.
Pigmented Villonodular Synovitis (PVNS)
This is a tumorous proliferation of a synovial origin which at times has been classified as an inflammatory condition.
It shows itself in variety of patterns and can be localized to one area of the knee or involve the entire synovial space of the knee.
This condition usually is seen in adults in midlife. In most cases patients may experience pain, swelling, locking, stiffness and sometime giving way feeling.
Although radiographic studies and Magnetic Resonance Imaging (MRI) may suggest some clues for diagnosis, but definitive diagnosis is with arthroscopy, visualization of the lesion and microscopic studies via tissue biopsy.
Prior to arthroscopy if knee is aspirated (drained) there may be presence of reddish or brownish color fluid which will raise the suspicion for (PVNS).
Treatment is usually surgical and this can be accomplished by arthroscopic surgery or in some circumstances there may be a need for open surgery and removal of the synovium (lining of the knee).