Fibroma (ankle joint)

Case contributed by Dr Maulik S Patel

Presentation

Pain involving anteromedial side of the left ankle for the last few weeks. Pain during dorsiflexion. No trauma.

Patient Data

Age: 20 years
Gender: Male
Ultrasound

There is a well-defined soft tissue lesion (about 15 x 12 x 8 mm) from the anteromedial side of the tibiotalar joint. The lesion is homogeneously hypoechoic. There is no calcification/ cystic change. Vascularity could not be demonstrated in the lesion. The lesion limits the dorsiflexion of the ankle.

There is mild effusion in the anterior recess of the ankle joint. The anterior talofibular ligament, calcaneofibular ligament, anterior inferior tibiofibular ligament, and deltoid ligament are normal.

Photo

1st photo shows an intraarticular lesion in the ankle joint. 2nd photo is a gross specimen.

Postoperative 9 months. Asymptomatic status.

Ultrasound

There is no residual lesion or recurrence. Local scar shows hypoechoic echopattern.

Case Discussion

A young male presented with the non-traumatic onset of the ankle pain with restricted dorsiflexion of the foot. Ultrasound shows an intraarticular lesion involving the anteromedial side of the ankle joint.

Surgical excision of the lesion was done and histopathology revealed the lesion being a fibroma.

Intraoperative and gross specimen photos courtesy: Operating surgeon Dr. Ritesh Patel.

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