Pigmented Villonodular Synovitis: A Rare Case of Anterior Ankle Impingement

Anterior ankle impingement is characterized by a painful range of motion (ROM)limitation of tibiotarsal joint. More than 70% of cases are secondary to trauma or repetitive microtrauma of the anterior aspect of the ankle such as it occurs during ball kicking ("footballer's ankle") or forced plantar flexion (ballet dancers, volleyball players, and runners) in people practicing sport for many years. There are other causes of anterior ankle impingement. We report a case of villonodular synovitis that, also less common, has to be considered in diagnostic flowchart. In this paper, we report a rare case of pigmented villonodular synovitis (PVNS) in a 37-year-old Caucasian male soccer player, with a 4-year story of ankle swelling and ROM painful limitation. PVNS, although it is an unusual cause of anterior ankle impingement, needs an early diagnosis and surgical excision to prevent extra-articular extension of the mass, cartilage damage, and soft tissue compression.