Primary bone lymphoma of the talus : a challenging diagnosis

Purpose: Diagnostic challenges are common in clinical practice and diagnostic or classification criteria for muscu-loskeletal conditions cannot overshadow clinical skills. Methods: We present the case of a young man who complained of prolonged articular pain and mild swelling of the right ankle in the absence of other remarkable data. Apparently fulfilling the Budapest diagnostic criteria for complex regional pain syndrome, the patient was treated accordingly, but the pain increased over time. Then the patient underwent an additional diagnostic workup including synovial and bone biopsies in 2 separate occasions with the second one demonstrating diffuse lymphoid infiltrate compatible with lymphoma. Results: The conclusive diagnosis of primary diffuse large B-cell lymphoma of the talus was made and adequate treatment initiated. Conclusions: The diagnostic difficulties as well as the importance of a multidisciplinary approach for complex cases are highlighted in this report.