Simultaneous involvement of pigmented villonodular synovitis in the left shoulder glenohumeral joint and ankle joint:...

Pigmented Villonodular Synovitis, although uncommon, can lead to significant joint destruction if not diagnosed and treated early. Concurrent polyarticular presentation in adults is exceedingly rare, appearing in less than 1% of cases.

This case report presents a unique and rare occurrence of Pigmented Villonodular Synovitis involving both the ankle and shoulder joints simultaneously in an adult patient. The patient initially developed a diffuse form Pigmented Villonodular Synovitis in the left ankle, which was managed with total synovectomy at another tertiary hospital. Two months later, a separate localized form Pigmented Villonodular Synovitis was diagnosed in the left glenohumeral joint, necessitating arthroscopic marginal resection at our hospital. At the one-year follow-up, the magnetic resonance imaging of the left shoulder showed no signs of Pigmented Villonodular Synovitis recurrence, with full range of motion and no pain. However, the magnetic resonance imaging of the left ankle revealed a recurrence of the Pigmented Villonodular Synovitis, despite the range of motion remaining within normal limits.

This case demonstrates the importance of considering multiarticular Pigmented Villonodular Synovitis when symptoms manifest in multiple joints. Early diagnosis and appropriate intervention are critical to prevent joint destruction and optimize patient outcomes.