Description of patient (type of occupation, indication of age, intensity of sport):
A patient referred to my outpatient for ankle pain
History and previous treatment:
The patient underwent to an open removal of an intra-articular giant cell tumor of the ankle
Current complaints:
Ankle pain
Physical examination:
Pain at palpation of the ankle
Radiology:
X-ray:
No radiological anormalities
Additional investigation (CT/MRI):
[Picture 1]
MRI showed a recurrence of the tumor
Images:
Case summary:
Recurrence of giant cell tumor of the ankle.
Question(s) to this case:
Can I perform an arthroscopic removal on a recurrence?
Expert:
This is nowadays regarded as PVNS Loclised type. (See review vd Sande et al.) I take it this is the only MRI location of the tumor? If is not localised you should perform open synovectomy. Theoretically you can remove localised like this arthroscopically. However this location is dangerous beause of neurovascular bundle. So take care not to remove to much and not to little. Better probably to do it open!