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Pigmented villonodular synovitis of the midfoot
P Sierens1, M Shahabpour, V Gombault
1Department of Radiology, Universitair Ziekenhuis Brussel, Brussels, Belgium.
Summary
A rare case of pigmented villonodular synovitis (PVNS) presented in a 60-year-old man. This study highlights unusual imaging findings and late-onset presentation of this foot disorder.
Area of Science:
- Orthopedics
- Radiology
- Pathology
Background:
- Pigmented villonodular synovitis (PVNS) is a rare, benign neoplastic proliferation of the synovium.
- It typically affects younger adults and commonly involves the knee, hip, or ankle.
Observation:
- A 60-year-old man presented with a slowly growing dorsal midfoot swelling.
- Imaging revealed bony erosions, a bifocal lesion, and unusual T2 signal characteristics on MRI, with one component suggesting hemosiderin and the other being hyperintense.
Findings:
- CT demonstrated bony erosions.
- MRI findings, while atypical for PVNS (specifically the hyperintense T2 component), were suggestive of the condition.
- Pathological confirmation established the diagnosis of PVNS.
Implications:
- This case underscores the importance of considering PVNS even with atypical imaging features and late-onset presentation.
- The bifocal nature and late age of onset are uncommon characteristics for PVNS, expanding the understanding of its varied presentation.
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