Age / Sex : 45 / M

Chief complaint : Swelling and pain of the right ankle for one year

What is your diagnosis?

Two weeks later, you can see the final diagonosis with a brief discussion of this case (Please submit only one answer).

Courtesy: 최윤선, Yun Sun Choi 노원을지대학교병원, Nowon Eulji Medical Center, Eulji University

Pigmented villonodular synovitis (PVNS)

Discussion

Findings

1.Radiograph: Bulging of the ankle joint capsule with suspicious erosions of the distal tibia and talus

2.MRI (T1, FST2, PD): Multifocal synovial based masses having intermediate to low signal intensity and effusion with fluid-fluid level in the ankle joint

1. Hemophilia-related arthropathy


2. Amyloid arthropathy


3. Synovial chondromatosis

1. Kransdorf MJ, Murphey MD. Imaging of soft tissue tumors. 3rd ed. Philadelphia: Lippncott Williams & Wilkins, 2014:472-481


2. Murphey MD, Rhee JH, Lewis RB, Fanburg-Smith JC, Flemming DJ, Walker EA. Pigmented villonodular synovitis: radiologic-pathologic correlation. Radiographics. 2008;28(5):1493-1518