Pigmented villonodular synovitis of the hip in a recreational runner: a case report.

Objective: To present the diagnostic, clinical, and radiological features of pigmented villonodular synovitis (PVNS), create awareness of this rare condition, and provide guidance for conservative healthcare practitioners for further referral and appropriate management.

Case Presentation: We present the case of a 41-year-old recreational runner who presented to the clinic with anterior hip pain of one year duration. Following a clinical history and examination, the patient was diagnosed with clinical femoroacetabular impingement. Radiographs taken at that time displayed mild degenerative joint disease of the left hip joint with coxa profunda. After four weeks of conservative care, the patient reported no improvement in symptoms. The patient was then referred for an MRI, while conservative care continued. Ten weeks later, the patient's symptoms and functional abilities had worsened. The MRI was obtained and the diagnosis of PVNS was made.

Summary: PVNS is a rare disease that can mimic mechanical hip pain. A high index of suspicion should be utilized when symptoms worsen despite conservative care. Referral for advanced imaging is critical for appropriate diagnosis of PVNS.