Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with chronic, progressive ankle pain, swelling, and stiffness. Reports intermittent locking or catching sensations. No history of acute trauma. Symptoms are refractory to conservative management, including NSAIDs and physical therapy.
Clinical Examination Findings
Inspection reveals localized swelling, often with a boggy consistency, typically along the anterior or lateral ankle joint line. Palpation demonstrates tenderness and potential palpable mass. Range of motion is restricted, particularly in dorsiflexion/plantarflexion, with possible crepitus. Neurovascular status is intact distally.
Treatment Protocol
Recommended treatment includes surgical synovectomy (arthroscopic or open) for complete excision of the proliferative synovial tissue. Post-operative management involves immobilization, progressive range of motion exercises, and physical therapy. Consider adjuvant radiotherapy or systemic therapy (e.g., CSF1R inhibitors) in cases of recurrence or diffuse involvement.