DOI: https://doi.org/10.36347/sjmcr.2025.v13i10.087

Pages: 2550-2554

Pigmented villonodular synovitis (PVNS) is a rare, benign but locally aggressive proliferative disorder of the synovial membrane, most commonly affecting large joints such as the knee. We report the case of a 65-year-old male presenting with progressive bilateral knee pain, limited mobility, and joint cracking. MRI revealed diffuse synovial thickening with villous and nodular projections, hemosiderin deposition, and marked blooming on T2* sequences, consistent with PVNS, in addition to complete ACL rupture, medial meniscus tear, tricompartmental osteoarthritis, and a Baker’s cyst. This case highlights the pivotal role of MRI in diagnosis, assessment of associated joint damage, and surgical planning.