{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T11:13:59Z","timestamp":1783509239242,"version":"3.55.0"},"reference-count":54,"publisher":"MDPI AG","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,3,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Pigmented villonodular synovitis (PVNS) is a rare disorder around the ankle joint. The optimal treatment for diffuse-type PVNS is still controversial because of the high incidence of recurrence. We present the clinical features of our patients and review the current diagnostic and treatment modalities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Five patients with PVNS located around the ankle were surgically treated. In three patients, diffuse PVNS arose from the ankle joint, and in the other two it arose from the calcaneocuboid and intercuneiform joints. The average follow-up time after surgery was 2.9 years (range, 2\u20134.6 years).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>The average time between onset of pain and diagnosis of PVNS was 6.4 years (range, 4\u201310 years). Arthrotomic tumor resection was performed in all of the patients. In the three patients with ankle joint PVNS, both medial and lateral approaches were used. One patient experienced mild infection at the surgical site, but this healed conservatively. No tumor recurrences had occurred after minimum follow-up of 2 years, although mild pain persisted in the three patients with ankle PVNS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Diagnosis of diffuse PVNS is frequently delayed due to vague symptoms and variable growth patterns. Orthopedic clinicians should be aware of the existence of this lesion, and it should be suspected in patients with persistent ankle swelling. To prevent tumor recurrence, accurate evaluation of tumor location and careful operative planning are mandatory. A combined surgical approach involving medial and lateral incision is necessary to expose the entire joint cavity.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.7547\/16-100","type":"journal-article","created":{"date-parts":[[2018,4,10]],"date-time":"2018-04-10T12:55:11Z","timestamp":1523364911000},"page":"140-144","source":"Crossref","is-referenced-by-count":6,"title":["Diffuse Pigmented Villonodular Synovitis Around the Ankle"],"prefix":"10.3390","volume":"108","author":[{"given":"Keiichi","family":"Muramatsu","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery, Yamaguchi University School of Medicine, Ube, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryuta","family":"Iwanaga","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Yamaguchi University School of Medicine, Ube, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasuhiro","family":"Tominaga","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Yamaguchi University School of Medicine, Ube, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takahiro","family":"Hashimoto","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Yamaguchi University School of Medicine, Ube, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshihiko","family":"Taguchi","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Yamaguchi University School of Medicine, Ube, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","reference":[{"key":"ref101","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1053\/j.jfas.2004.09.002","article-title":"Pigmented villonodular synovitis of the foot and ankle: a 12-year experience from a tertiary 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villonodular synovitis","volume":"114","author":"Granowitz","year":"1976","journal-title":"Clin Orthop Relat Res"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"877","DOI":"10.2214\/ajr.143.4.877","article-title":"Pigmented villonodular synovitis of synovial joints: clinical, pathologic, and radiologic features","volume":"143","author":"Dorwart","year":"1984","journal-title":"Am J Roentgenol"},{"key":"ref141","first-page":"463","article-title":"Cell populations involved in pigmented villonodular synovitis of the knee","volume":"27","author":"Oehler","year":"2000","journal-title":"J Rheumatol"},{"key":"ref21","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1007\/BF00453142","article-title":"Pigmented villonodular synovitis","volume":"109","author":"Klompmaker","year":"1990","journal-title":"Arch Orthop Trauma Surg"},{"key":"ref351","doi-asserted-by":"crossref","first-page":"415","DOI":"10.7547\/0970415","article-title":"Clinical and radiologic features of pigmented 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excision","volume":"6","author":"Schweitzer","year":"2013","journal-title":"Foot Ankle Spec"},{"key":"ref421","first-page":"26","article-title":"Cytokine and matrix metalloproteinase expression in pigmented villonodular synovitis may mediate bone and cartilage destruction","volume":"18","author":"O'Keefe","year":"1998","journal-title":"Iowa Orthop J"},{"key":"ref151","first-page":"26","article-title":"Cytokine and matrix metalloproteinase expression in pigmented villonodular synovitis may mediate bone and cartilage destruction","volume":"18","author":"O'Keefe","year":"1998","journal-title":"Iowa Orthop J"},{"key":"ref431","first-page":"110","article-title":"Expression of matrix metalloproteinases and tissue inhibitors of metalloproteinases in pigmented villonodular synovitis suggests their potential role for joint destruction","volume":"31","author":"Uchibori","year":"2004","journal-title":"J Rheumatol"},{"key":"ref241","first-page":"99","article-title":"Open synovectomy with cryosurgical adjuvant for treatment of diffuse pigmented villonodular synovitis of the knee","volume":"59","author":"Mohler","year":"2000","journal-title":"Bull Hosp Jt Dis"},{"key":"ref381","doi-asserted-by":"crossref","first-page":"1532","DOI":"10.2106\/00004623-199173100-00011","article-title":": X-chromosome inactivation in patients who have pigmented villonodular synonitis","volume":"73","author":"Sakkers","year":"1991","journal-title":"J Bone Joint Surg Am"},{"key":"ref311","doi-asserted-by":"crossref","first-page":"527","DOI":"10.3113\/FAI.2008.0527","article-title":"Pigmented villonodular synovitis about the ankle: two case reports","volume":"29","author":"Heller","year":"2008","journal-title":"Foot Ankle Int"},{"key":"ref301","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1097\/00005792-198005000-00004","article-title":"Pigmented villonodular synovitis and tenosynovitis: a clinical and epidemiologic study of 166 cases and literature review","volume":"59","author":"Myers","year":"1980","journal-title":"Medicine"},{"key":"ref451","doi-asserted-by":"crossref","first-page":"413","DOI":"10.1177\/107110079601700710","article-title":"Extra-articular localized nodular synovitis (giant cell tumor of tendon sheath origin) attached to the subtalar joint","volume":"17","author":"Villani","year":"1996","journal-title":"Foot Ankle Int"},{"key":"ref31","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1097\/00005792-198005000-00004","article-title":"Pigmented villonodular synovitis and tenosynovitis: a clinical and epidemiologic study of 166 cases and literature review","volume":"59","author":"Myers","year":"1980","journal-title":"Medicine"},{"key":"ref461","doi-asserted-by":"crossref","first-page":"469","DOI":"10.1007\/s002560100373","article-title":"Pigmented villonodular synovitis of the hip presenting as a retroperitoneal mass","volume":"30","author":"Kallas","year":"2001","journal-title":"Skeletal 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