Médecine et chirurgie du pied


Pigmented villonodular synovitis of the ankle: case report and review of the literature Volume 24, issue 3, Septembre 2008


Pigmented villonodular synovitis (PVNS) is a benign pseudotumoral disorder, of unknown pathogenesis, that often affects the young adult. The most affected joints are the knee and hip and it very rarely affects the ankle, with only a few cases having been reported in the literature. We report a new case of diffuse PVNS of the ankle in a 76-year-old patient, presenting with tumefaction at the circumference of the talocrural articulation, which was painless, had appeared rapidly and had no visible signs of inflammation. The clinical examination showed a firm, only slightly mobile, mass in the soft parts, with a creaking, cracking sensation when the ankle was moved and with neither neurological nor vascular disorders in the homolateral foot. The standard radiography showed significant narrowing of the ankle joint space with loss of osseous tissue and numerous periarticular calcifications. The syphilitic serology as well the inflammatory tests were negative. A subtotal surgical synovectomy was carried out, revealing total lysis of the cartilage and destruction of the subchondral bone. The histopathologic examination confirmed the diagnosis of PVNS. One year later there does not appear to have been any recurrence and instability of the ankle is still the main difficulty.