Ghert M A, Scully S P, Harrelson J M
Division of Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina 27710, USA.
Foot Ankle Int. 1999 May;20(5):326-30. doi: 10.1177/107110079902000512.
Pigmented villonodular synovitis is a rare but well recognized proliferative lesion of synovial tissue. It has been most commonly described in the knee and hip, with most series reporting <5% occurrence in the foot and ankle. Six patients with pigmented villonodular synovitis of the foot and ankle that was treated between 1978 and 1997 were reviewed. Four of the patients had not been previously diagnosed, and two patients presented with recurrent disease. All six were women. Two patients' disease presented isolated to the ankle joint. The other four involved more than one joint: subtalar joint and midfoot in two, and the metatarsal region in two. The histology of the primary and recurrent lesions did not differ. The recurrent lesions were more diffuse and locally destructive. Five were found on magnetic resonance imaging to be a low-to-medium signal intensity mass on T1- and T2-weighted images. Surgical management ranged from simple excision to synovectomy to Lisfranc amputation. Average follow-up was 13 months (range, 3 weeks to 51 months). One of the lesions recurred 4 years later.
色素沉着绒毛结节性滑膜炎是一种罕见但已得到充分认识的滑膜组织增生性病变。它最常发生于膝关节和髋关节，大多数病例系列报道其在足踝部的发生率<5%。本文回顾了1978年至1997年间接受治疗的6例足踝部色素沉着绒毛结节性滑膜炎患者。其中4例此前未被诊断，2例为复发性疾病。所有6例均为女性。2例患者的疾病仅累及踝关节。另外4例累及一个以上关节：2例累及距下关节和中足，2例累及跖骨区域。原发性病变和复发性病变的组织学表现无差异。复发性病变更弥漫且具有局部破坏性。5例在磁共振成像上表现为T1加权像和T2加权像上低至中等信号强度的肿块。手术治疗范围从简单切除到滑膜切除术再到Lisfranc截肢术。平均随访13个月（范围，3周-51个月）。其中1例病变在4年后复发。
