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Joint Tumors

By Michael J. Joyce, MD, Associate Clinical Professor, Orthopaedic Surgery, Cleveland Clinic Lerner School of Medicine at Case Western Reserve University ; Hakan Ilaslan, MD, Associate Professor of Radiology;Staff Radiologist, Cleveland Clinic Lerner College of Medicine at Case Western Reserve University;Imaging Institute, Diagnostic Radiology

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Tumors rarely affect joints unless a bone tumor or soft-tissue tumor is near a joint. However, two conditions—synovial chondromatosis and pigmented villonodular synovitis—occur in the lining (synovium) of joints. These tumors are noncancerous (benign) but can cause severe damage to the joint. Both conditions usually affect one joint, most often the knee or the hip, and can cause pain and a buildup of fluid.

To diagnose these conditions, doctors do x-rays, computed tomography (CT), magnetic resonance imaging (MRI), or a combination.

Treatment for both requires surgical removal of the abnormal synovium (called synovectomy).

Pigmented villonodular synovitis

Pigmented villonodular synovitis causes the lining of the joint to become swollen and grow. This growth harms the cartilage and bone around the joint. The lining also produces extra fluid that can cause pain and swelling. The process often causes bloody fluid to appear in the joint. It usually affects one joint.

A total joint replacement may be needed if the condition returns after treatment. On rare occasions after several synovectomies, radiation therapy is sometimes given.

Synovial chondromatosis

Synovial chondromatosis (previously called synovial osteochondromatosis) is a condition in which cells in the lining of the joint turn into cartilage-producing cells. These converted cells can form clumps of cartilage, which then shed into the space around the joint, forming loose bodies that may be no larger than a grain of rice, and cause pain and swelling. This condition rarely becomes cancerous (malignant).

If symptoms are severe, the loose bodies are removed along with the abnormal synovium. This condition commonly returns after treatment.

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