Revista Biomédica Revisada Por Pares
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Palabras clave: synovitis, pigmented villonodular, arthritis
Pigmented villonodular synovitis is a benign tumor of synovial tissue with a very low incidence. Ankle location is even less frequent. Early diagnosis and management are required to avoid irreversible functional and mechanical sequelae. The clinical presentation starts with edema or joint effusion and may progress with pain and advanced joint degenerative changes. Pigmented villonodular synovitis can be focal or diffuse, the latter being the type with the worst prognosis. When suspected, magnetic resonance imaging is performed, and the diagnosis confirmed with a biopsy in which synovial inflammatory tissue with hemosiderin deposits is observed. An open or arthroscopic synovectomy is preferred over surgical management. Recurrence is up to 40%, which is why biological coadjutant therapies and radiotherapy are described. This article presents the case of a 30-year-old man who presented with pain and claudication of the left ankle; the imaging study findings were compatible with diffuse pigmented villonodular synovitis of the ankle with extension to the subtalar joint, leading to arthroscopy for treatment and biopsy. This case report illustrates the results with this patient and a literature review of the subject.
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Pigmented villonodular synovitis is a benign tumor of synovial tissue with a very low incidence. Ankle location is even less frequent. Early diagnosis and management are required to avoid irreversible functional and mechanical sequelae. The clinical presentation starts with edema or joint effusion and may progress with pain and advanced joint degenerative changes. Pigmented villonodular synovitis can be focal or diffuse, the latter being the type with the worst prognosis. When suspected, magnetic resonance imaging is performed, and the diagnosis confirmed with a biopsy in which synovial inflammatory tissue with hemosiderin deposits is observed. An open or arthroscopic synovectomy is preferred over surgical management. Recurrence is up to 40%, which is why biological coadjutant therapies and radiotherapy are described. This article presents the case of a 30-year-old man who presented with pain and claudication of the left ankle; the imaging study findings were compatible with diffuse pigmented villonodular synovitis of the ankle with extension to the subtalar joint, leading to arthroscopy for treatment and biopsy. This case report illustrates the results with this patient and a literature review of the subject.
Autores:
Soledad Salas González[1], Tomás Urrutia Jarpa[2], Jorge Filippi[2,3]
Citación: Salas González S, Urrutia Jarpa T, Filippi J. Arthroscopic treatment of pigmented villonodular synovitis of the ankle: a clinical case report and review. Medwave 2019;19(4):e7641 doi: 10.5867/medwave.2019.04.7641
Fecha de envío: 12/12/2018
Fecha de aceptación: 2/5/2019
Fecha de publicación: 27/5/2019
Origen: no solicitado
Tipo de revisión: con revisión por dos pares revisores externos, a doble ciego
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