PIGMENTED VILLONODULAR SYNOVITIS

May 20, 2004

" I had asked about the appropriateness of

> hip resurfacing as opposed to thr - I was diagnosed with pigmented

> villonodular synovitis last August and thr was the recommendation

by

> my orthopedic surgeon… "

Hi:

I am a radiologist and surface hippy (Dr. Vail 3/31/03 (L) C +

It may be that this particular condition is not amenable to

resurfacing because the treatment sometimes requires a complete

synovectomy. (Removal of the joint lining)

However, I am not an orthopedist and this is an uncommon condition.

It is more common in the knee, but can occur in any

" synovial "

joint. It is really one of several related benign tumors of the

joint lining. The name is old fashioned and is related to the fact

that the stringy, folded,overgrowth of the lining tends to bleed

minimally but repeatedly. The old blood " stains " or

" pigments " the

joint lining surface (to the naked eye). It has a characteristic

appearance on MRI and arthroscopy. It is hard to diagnose on plain x-

ray except very late in the process.

Don't delay because this condition can cause a lot of bone

destruction. Have your X-rays and MRI (I assume) and other records

reviewed by any of the resurfacing orthopedists. Don't worry

about

which " brand " it is that they are using.

If you can't have resurfacing, consider a " M-O-M " large

ball " THR or

one of the new ceramic THR's. Many of the advantages of

resurfacing

are provided by these devices.

To get the names and addresses of resurfacing orthopedists. Any of

them can give you a good evaluation.

Best wishes,

(MD) in North Carolina

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