A Rare Incidence of Pigmented Villonodular Synovitis of the Ankle in an Adolescent

Novikov, David; Richardson, Meghan W.; Ho, Corey K.; Gould, Elaine S.; Khan, Farhat Ullah

doi:10.1053/j.jfas.2018.03.029

Cited by 3 publications

(2 citation statements)

References 16 publications

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“…Surgical excision is a frequently employed therapeutic approach for treating PVNS; however, the specific treatment may vary according to the type and anatomical location of the condition. [ 5 ] For localized PVNS, most studies advocate complete resection of the lesion, and curettage of bone cysts or sites of bone erosion, which was the chosen surgical approach in our case [ 13 , 14 , 17 ]. In patients with diffuse PVNS, incomplete resection, or local recurrence, adjunctive and neoadjuvant treatments such as radiation therapy and cryotherapy are recommended [ 18 – 20 ].…”

Section: Discussionmentioning

confidence: 99%

Unusual presentation of talonavicular joint pigmented villonodular synovitis: a case report

Elahifar,

Torkaman,

Ghaeini

et al. 2024

J Med Case Reports

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Background Pigmented villonodular synovitis is a rare yet locally invasive disorder impacting synovial tissues. This case report delineates the atypical manifestation of pigmented villonodular synovitis in the talonavicular joint, detailing its diagnostic complexity and successful management. Case presentation A 56-year-old Iranian patient with a 4-year history of chronic ankle pain, initially diagnosed with degenerative joint disease post-trauma based on imaging, underwent talonavicular fusion surgery. An unexpected pigmented villonodular synovitis mass was encountered during the procedure. Subsequent interventions encompassed tumor resection, talonavicular joint fusion, and allograft bone grafting. Despite the initial intervention, persistent pain and nonunion necessitated a secondary procedure, involving joint surface curettage and autograft bone grafting. At the 12-month follow-up, the patient remained pain-free without tumor recurrence. Conclusion This case report highlights the significance of considering pigmented villonodular synovitis as a crucial differential diagnosis in chronic ankle pain, even when there is evidence of degenerative joint disease and a history of trauma. Magnetic resonance imaging serves a crucial role in accurate diagnosis. Treatment necessitates precise tumor removal, appropriate bone grafting techniques and secure fixation. Level of evidence: IV.

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Section: Discussionmentioning

confidence: 99%

Unusual presentation of talonavicular joint pigmented villonodular synovitis: a case report

Elahifar,

Torkaman,

Ghaeini

et al. 2024

J Med Case Reports

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“…However, there is a clear tendency in the literature toward arthroscopic treatment of LPVNS, when localized in anterior ankle recess [ 7 , 8 , 9 , 10 ]. Our review of the recent literature on surgical management for LPVNS situated in the posterior ankle recess found only five case reports (six cases) ( Table 1 ) [ 11 , 12 , 13 , 14 , 15 ]. In all six cases, LPVNS was managed using open surgical approaches and showed no recurrence, at the mean follow-up of 3.9 years.…”

Section: Discussionmentioning

confidence: 99%

Hindfoot Endoscopy for the Treatment of Localized Pigmented Villonodular Synovitis

Levaj¹,

Dimnjaković²,

Bojanić³

2022

JOCR

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Introduction: Pigmented villonodular synovitis (PVNS) is a rare and benign proliferative lesion affecting synovial lining of joints, bursae, and tendon sheaths. Depending on the extent of synovial involvement, two forms are distinguished, diffuse, and localized. Intra-articular localized form of PVNS (LPVNS) presents as a nodular, well circumscribed, pedunculated, or sessile soft-tissue mass. Case Presentation: We report a case of an unusual localization of LPVNS in posterior ankle recess in a 42-year-old male with concomitant anterior ankle impingement syndrome. To address both the posterior and the anterior ankle disorders the patient was treated with combined two-portal endoscopic hindfoot approach and anterior ankle arthroscopy within the same operative session. The hindfoot endoscopy encompassed complete removal of the localized mass, partial synovectomy of the area at the base of the lesion, removal of os trigonum, and a loose body impinged in the interval between tibia and fibula. The anterior ankle arthroscopy included removal of the osteophytes from the anterior distal tibia and dorsal talus. Patient continued his normal daily and sporting activities without any restrictions and no recurrence of LPVNS 2 years after the surgery. Conclusion: PVNS is an important clinical entity that should always be thought of as a differential diagnosis when treating patients with ankle disorders. Hindfoot endoscopy, when performed by an experienced ankle surgeon, is a safe and effective procedure for LPVNS of the posterior ankle recess, when deemed amenable to complete resection.

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Pigmentierte villonoduläre Synovitis

2022

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Zusammenfassung Ziel In diesem Beitrag wird evaluiert, ob die radiologischen Diagnosekriterien ausreichen, um die Diagnose einer pigmentierten villonodulären Synovitis (PVNS) anhand eines Magnetresonanztomographie(MRT)-Befunds sicher stellen zu können und daraus eine Operationsindikation abzuleiten. Hierzu wurde überprüft, inwieweit die radiologische Diagnose mit dem histopathologischen Befund übereinstimmte. Methoden In einer retrospektiven Datenanalyse wurden 52 Patienten mit PVNS (22 männlich, 30 weiblich, mittleres Alter: 38 Jahre), die sich zwischen 1991 und 2019 einem operativen Eingriff unterzogen hatten, analysiert. Einschlusskriterien waren ein positiver MRT-Befund mit Hinweis auf Hämosiderin und anschließende Synovektomie sowie eine entsprechend dokumentierte histopathologische Aufarbeitung. Ergebnisse In 71 % der Fälle stimmten der MRT-Befund und das histologische Ergebnis überein, was jedoch darauf hindeutet, dass nach der radikalen Synovektomie in etwa 29 % der Fälle histologisch keine PVNS nachgewiesen werden konnte. Das Kniegelenk stellte sich als das am häufigsten betroffene Gelenk dar, gefolgt von Hüft- und Sprunggelenk. Diskussion Die PVNS tritt meist bei jungen Erwachsen auf. Frauen waren im eigenen Kollektiv etwas häufiger betroffen als Männer. In der aktuellen Literatur findet man keinen etablierten Algorithmus zur Behandlung einer PVNS. Im Zweifelsfall sollte unbedingt eine histologische Diagnosesicherung mittels arthroskopischer oder offener Biopsiegewinnung der radikalen Synovektomie vorgeschaltet werden. Schlussfolgerung Aufgrund der Invasivität der radikalen Synovektomie ist die präoperative Biopsie eine weitere Möglichkeit zur Diagnosesicherung und sollte im Zweifelsfall unbedingt eingesetzt werden. Eine enge interdisziplinäre Zusammenarbeit von Radiologen und Tumorradiologen ist hierbei essenziell.

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A Rare Incidence of Pigmented Villonodular Synovitis of the Ankle in an Adolescent

Cited by 3 publications

References 16 publications

Unusual presentation of talonavicular joint pigmented villonodular synovitis: a case report

Unusual presentation of talonavicular joint pigmented villonodular synovitis: a case report

Hindfoot Endoscopy for the Treatment of Localized Pigmented Villonodular Synovitis

Pigmentierte villonoduläre Synovitis

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