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Preoperative X-rays do not reveal the mass (A), but MRI suggesting talar destruction (red arrow) and joint hydrops (B). (For interpretation of the references to colour in this figure legend, the reader is referred to the web version of this article).
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MRI suggested a space-occupying lesion on the anteromedial aspect of the talus, ankle joint hydrops (Fig. 1), and abnormal diffuse signals of the talus.
Cherry-red elevated tumor in the anteromedial portion of the talus (A) removed using combination of shaver (B) and arthrocare (C), leaving 12-mm crater (D).
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The mass was resected completely under arthroscopy: 1. synovectomy to expose the mass well; 2. biopsy performed with a pair of nucleus pulposus forceps to obtain tissue specimens for histopathologic analysis; 3. the remainder of the lesion was debrided with a shaver (2.9 mm in diameter), 4. treatment of the damaged surface with Arthrocare 2000 System (Fig. 2).
Pathologic study of talar tumor showing interconnecting trabeculae of woven bone with prominent osteoblastic rimming (HE, x 200).
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These histologic findings are typical of a nidus and in accordance with our preliminary diagnosis of osteoblastoma (Fig. 3).
MRI performed three years after surgery suggested a little fibrous scar tissue in the lesion of left talus (red arrow), without tumor tissue recurrence. (For interpretation of the references to colour in this figure legend, the reader is referred to the web version of this article).
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MRI performed three years after surgery suggested a little fibrous scar tissue in the lesion of left talus, without tumor tissue recurrence (Fig. 4).
The left ankle joint appeared normal and functioned normally after surgery. (A and B).
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He had no recurrent pain and normal joint mobility 5 years postoperatively (Fig. 5) during he was regularly followed up.