Synovial disorders of the hip

The hip is a synovial joint which links the axial skeleton to that of the lower extremity by the articulation of the femur and acetabulum. The tissue of the synovium which lines the joint has the important role of regulation of synovial fluid production but also can be a source of significant but rare pathology. These disorders include synovial chondromatosis and pigmented villonodular synovitis (PVNS). Synovial chondromatosis will typically present with monoarticular pain and stiffness with mechanical complaints of locking and catching during the third to fifth decade of life due to the generation of loose bodies. Pigmented villonodular synovitis is another benign proliferative disorder of the synovium. While the lesion is benign, it can be locally aggressive and cause the destruction of both intra- and extra-articular structures in the third and fourth decades of life. Both disorders are treated with arthroscopic or open debridement with synovectomy. Synovial disorders of the hip are fortunately very rare but can be devastating. Surgical treatment, when undertaken in a timely fashion, can be effective at preserving hip function.