Social Security Disability Attorneys in Riverside, North San Diego & Orange Counties
Pigmented Villonodular Synovitis (PVNS)
Pigmented villonodular synovitis (PVNS) is a rare condition that by some estimates occurs in approximately 44 individuals per 100,000 in the localized form (in which only a portion of a joint such as the knee is involved) and 11 per 100,000 in the diffuse form (involving the entire joint, including the tendons). [Ref: National Institutes of Health, https://rarediseases.info.nih.gov/diseases/7396/pigmented-villonodular-synovitis]
In PVNS, the tissues that line the joint, called the “synovium,” become inflamed, much like in arthritis, and begin to form a mass that enlarges gradually. Symptoms can include pain, swelling (sometimes dramatic), limitation of movement, and locking of the joint. In some cases, the normal joint structure can be destroyed. The knee is the most commonly affected joint, followed by the hip. But it can occur in other joints such as the shoulder, elbow, ankle, wrist, finger, and rarely the jaw. The average age of diagnosis for this condition is 35 years. The cause of PVNS is unknown. Treatment involves surgery to remove the tumor and damaged portions of the joint. Id.
The cause of this rare condition is not known. However, more than half of persons who develop PVNS have a history of a prior injury to the joint.
The diagnosis of PVNS is usually made by taking x-rays or performing an MRI of the involved joint. Aspiration of the joint may reveal bloody fluid inside the joint. A biopsy of the tissue will confirm the diagnosis.
Treatment usually requires surgery to remove the lesion. Radiation is sometimes used. PVNS is not a malignancy and it does not metastasize, but it behaves somewhat like a benign tumor in that it slowly enlarges if not removed and can result in damage to the joint.
The American Academy of Orthopedic Surgeons indicates that surgical treatments may include arthroscopy, open surgical excision, or a combination of arthroscopic and open surgery. This combined method decreases the scale of surgery, allowing for an easier recovery. Total joint replacement may be necessary when PVNS has been allowed to progress to the point that it destroys the joint. [Ref: https://orthoinfo.aaos.org/en/diseases--conditions/pigmented-villonodular-synovitis]
Localized PVNS usually has an excellent prognosis and typically does not recur following definitive surgery. However, diffuse PVNS may cause problems and recur in 10-30% of patients, requiring retreatment with additional surgery or radiation.
Disability benefits for persons with PVNS, either through Social Security (SSDI) and/or an employer-provided long-term disability (LTD) group plan (ERISA), are awarded when there is adequate medical documentation (usually from an orthopedic surgeon) of a functional impairment that prevents you from working. Because PVNS usually affects the knee or the hip, persons may be disabled from occupations that require standing and walking.
While there is no SSDI “listing” for PVNS, evaluations for disability usually follow the guidelines set forth in section 1.00 – Musculoskeletal System. For example, if you are unable to walk or stand for at least 2 hours out of an 8-hour workday because of a damaged knee or hip, you may qualify for disability benefits.
The diffuse form of PVNS, because it can be refractory to treatment and because it has a tendency to recur after treatment, may more easily qualify for a disability award. Even with treatment, PVNS can come back about half the time.