Pigmented villonodular synovitis of 1st MTP joint: A case report

Abstract

Introduction & aims: Pigmented villonodular synovitis common disease entity particularly in the knee joint but its incidence in the foot is quite rare. Method: A 17 year old female presented to our institution with diagnosis of pigmented villonodular synovitis which had been operated once outside but recurred. Recurrence was confirmed with histopathology. After careful examination and investigations open excision was done. Patient remained pain free for 5 months but again started having pain at first metacarpophalangeal joint and treating physician thought that disease has recurred again After careful physical examination she was found to have a corn at the planter aspect of the first metacarpophalangeal joint. She was sent for the opinion of an expert dermatologist, who excised that corn. Results: Patient is now completely pain free even after one year of the surgical management. Conclusions: PVNS of the forefoot and 1st metatarsal joint, although reported earlier, is rare entity. This report signifies the importance of the differential diagnosis of pain in the foot and particularly in the weight bearing part of the foot and implies that recurrence should be considered only after careful examination.