A misdiagnosed case of shoulder pigmented villonodular synovitis – A case report

Background: Pigmented villonodular synovitis (PVNS) is a rare, benign proliferative synovial disorder that may involve joints, tendon sheaths, or bursae. Shoulder involvement, especially the extra-articular component, is extremely uncommon and present as a diagnostic challenge due to nonspecific sym...

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Bibliographic Details
Main Authors: Rachel Si Ning Loh, Winston Shang Rong Lim, Denny Tijauw Tjoen Lie, Henry Soeharno
Format: Article
Language:English
Published: Elsevier 2025-08-01
Series:Journal of Orthopaedic Reports
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Online Access:http://www.sciencedirect.com/science/article/pii/S2773157X25000384
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Summary:Background: Pigmented villonodular synovitis (PVNS) is a rare, benign proliferative synovial disorder that may involve joints, tendon sheaths, or bursae. Shoulder involvement, especially the extra-articular component, is extremely uncommon and present as a diagnostic challenge due to nonspecific symptoms like swelling, pain, and stiffness. We aim to highlight the importance of a comprehensive evaluation of shoulder swelling and provide clinically relevant insights into PVNS. Case report: A 46-year-old male presented with six months of shoulder swelling. It was associated with stiffness, and transient episodes of severe pain triggered by sudden jerking movements. The patient was initially misdiagnosed as rotator cuff tendinitis and sought further evaluation after conservative treatment failed. He underwent plain radiographs, magnetic resonance imaging and was successfully treated with a combined arthroscopic mini-open surgery with good clinical results at the nine months follow-up. The histopathological report confirmed a diagnosis of an extra-articular PVNS of the shoulder. Conclusion: A systematic approach to shoulder swelling and knowledge of current and controversial treatment options of PVNS are essential. This allows early diagnosis and appropriate management which are fundamental to achieving favourable outcomes in shoulder PVNS.
ISSN:2773-157X