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A previously well 30 year old man presented with a short history of intra-articular mechanical locking, swelling, and anteromedial joint line pain. There was localised tenderness, and McMurray's test was positive. Arthroscopy revealed a 3.6 x 2.6 x 1.5 cm firm pedicular localised pigmented villonodular synovitis originating from the insertion of the anterior horn of the medial meniscus. Owing to its size and consistency, mini-arthrotomy was required. This allowed a return to sporting activities. Localised pigmented villonodular synovitis can mimic symptoms of a meniscal tear.
Knee problems account for a large portion of physiotherapy and orthopaedic practice. Clinical history and good examination are of paramount importance. Many problems require no intervention and settle. Meniscal injury and tears of the anterior cruciate ligament are common, and a variety of surgical techniques have been described for their management. Radiological investigation and arthroscopy further assist in diagnosis, and …