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Joint Tumors

ByLukas M. Nystrom, MD, Cleveland Clinic Lerner College of Medicine and Case Western Reserve University
Reviewed/Revised Apr 2025
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Tumors rarely affect joints unless a bone tumor or soft tissue tumor is near a joint. However, 2 conditions—synovial chondromatosis and tenosynovial giant cell tumors (previously called 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 1 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. To confirm the diagnosis, doctors usually remove a tissue sample for examination under a microscope (biopsy).

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

(See also Overview of Bone Tumors.)

Tenosynovial giant cell tumor

Tenosynovial giant cell tumor (previously called pigmented villonodular synovitis [PVNS] and giant cell tumor of tendon sheath) 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 in the joint and can lead to arthritis. Tenosynovial giant cell tumor usually affects one joint.

The treatment is usually surgical, but recurrences are not infrequent. Pexidartinib, a medication taken by mouth, is used to diminish the tumor's growth, but only if symptoms are severe and not relieved by surgery. The treatment is usually surgical, but recurrences are not infrequent. Pexidartinib, a medication taken by mouth, is used to diminish the tumor's growth, but only if symptoms are severe and not relieved by surgery.Pexidartinib is available in the United States only in cancer centers through the manufacturer's Risk Evaluation and Mitigation Strategy Program. The medication can cause serious and potentially fatal liver injury in some people.

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 and is typically treated with surgery.

Synovial chondromatosis is diagnosed by imaging. Magnetic resonance imaging (MRI) is preferred because it is more sensitive at detecting the smaller loose bodies. Larger loose bodies can be detected by x-rays or computed tomography (CT) as they harden into bone.

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