Diffuse Pigmented Villo-Nodular Synovitis (PVNS) is a pan-articular disease with a natural history of degenerative changes in the long-term, that is, secondary osteoarthritis. Its peak incidence occurs in the fourth and fifth decade preceding that of primary osteoarthritis by 10-20 years. It tends to be mono-articular in presentation and has a high risk of recurrence. Identifying patients with secondary osteoarthritis and investigating for an underlying cause is the first step in avoiding undue morbidity in this patient population. The presentation of PVNS does not differ much from other causes of secondary osteoarthritis often resulting in a delay in diagnosis. It is therefore of great importance that a high index of suspicion be maintained as early detection of the disease process may allow joint conservative management options.
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