case_images: PMC6083480_01
case_images: Preoperative anterior-posterior and lateral radiographs of the left ankle joint showing no signs of any osseous destruction or joint damage.
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case_images: PMC6083480_01_CRIOR2018-8790916.001.jpg
case_images: fig1
case_images: Anterioposterior and lateral X-rays of the ankle joint did not show any signs of osteoarthritis or other osseous destruction (Figure 1).
case_images: T2-weighted axial magnetic resonance images demonstrating a soft tissue tumor along and around the peroneal tendons with hypo- and hyperintense central areals and an inhomogenous, diffuse uptake of the contrast agent (arrows), highly suspicious for a synovial sarcoma.
case_images: CRIOR2018-8790916.002.jpg
case_images: PMC6083480_01_CRIOR2018-8790916.002.jpg
case_images: fig2
case_images: MRI revealed a lesion of size of 4.3 x 2.7 x 3.7 cm in close relation to the peroneal tendons with hypo- and hyperintense central areals, especially in the inframalleolar area, and an inhomogenous, diffuse uptake of the contrast agent, highly suspicious for a synovial sarcoma (Figure 2).
case_images: Exposure of the tophaceous lesion after opening of the tendinous sheath of the peroneal tendons.
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case_images: PMC6083480_01_CRIOR2018-8790916.003.jpg
case_images: fig3
case_images: After opening of the tendinous sheath of both peroneal tendons, the tophaceous lesion was exposed (Figure 3).
case_images: The excised tophus.
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case_images: PMC6083480_01_CRIOR2018-8790916.004.jpg
case_images: fig4
case_images: The lesion was then excised from proximal to distal (Figure 4).
case_images: Following excision of the tophus, the gout infiltration of the tendons was evident.
case_images: CRIOR2018-8790916.005.jpg
case_images: PMC6083480_01_CRIOR2018-8790916.005.jpg
case_images: fig5
case_images: Both tendons of the peroneus brevis and longus were then prepared along their entire course and debrided from any remaining tophaceous infiltration (Figures 5 and 6).
case_images: The tendons of the peroneus brevis and longus were prepared along their entire course and debrided from all tophaceous infiltration.
case_images: CRIOR2018-8790916.006.jpg
case_images: PMC6083480_01_CRIOR2018-8790916.006.jpg
case_images: fig6
case_images: Both tendons of the peroneus brevis and longus were then prepared along their entire course and debrided from any remaining tophaceous infiltration (Figures 5 and 6).