Causes and risk factors
The exact cause of this condition is still a mystery. However, studies have shown that certain genetic factors are involved in its causation.
Clinical presentation:
Pigmented villonodular synovitis is classified into two classes – localized and diffuse. In diffuse type, usually the large joints are affected and intra-articular involvement is seen. While in the localized form, the small joints are affected and extra articular involvement is seen. Localized form is more commonly seen. The joints all over the body are affected, but mostly knee, hip, ankle, shoulder, elbow, and spine are affected. Unilateral affection is seen. Unlike any affection of the muscle or bone, pain is also a prominent feature. The pain is severe and is aggravated by the movement of that tendon. The overlying skin is warm to touch and tenderness is present. Swelling is seen at the affected area due to production of extra fluid by the synovium. Stiffness along with weakness while moving the affected joint is another complaint with which the patient can present. Eventually, destruction of the joint can lead to loss of function.
Investigations:
Diagnosis is done on the basis of the symptoms narrated by the patient and the physical examination carried out by the orthopedic doctor. Certain investigations which can be done are x-ray, MRI, or CT scan of the affected joint. Routine blood test and a profile of specialized blood tests are done to rule out other diseases. Joint aspiration and biopsy can also be done.
Treatment:
Rest, wearing braces and supports to hold the joint in alignment during movement, and cold compressions along with medication can be advised. Medications prescribed are nonsteroidal anti-inflammatory drugs (NSAIDs); steroids and pain relieving drugs are prescribed. In severe cases, corticosteroid injections and topical pain relieving gels and lubricants are advised. Surgical intervention is needed in case where the synovium is severely affected. Synovectomy is done. Radiation therapy can also be applied. In case where there is extensive destruction of joint, total joint replacement needs to be done. Regular exercises are advised.
Other Modes of treatment:
Certain other modes of treatment can also be helpful in coping up with the symptoms. Taking into consideration the symptoms in a holistic way, homoeopathy can offer a good aid for the relief of the symptoms. The Ayurvedic system of medicine which uses herbs and synthetic derivates can also be beneficial in combating the complaints. Acupuncture, which is the science of insertion of fine needles on the certain stimulating spots on the body, has been proven to be effective. Certain yoga exercises can also be helpful in relieving the pain and strengthening the muscles.
