Synovial chondromatosis of the metacarpophalangeal joint

We describe a case of synovial chondromatosis in a metacarpophalangeal joint with invasion of local structures. The degree of local tissue involvement was not demonstrated on the preoperative MRI scans. This case highlights that synovial chondromatosis can be invasive and that even the best preoperative imaging may not demonstrate this.     

Synovial chondromatosis of the metacarpophalangeal joint.

The authors present a case of synovial chondromatosis localized on the left hand of a woman and discuss the pathogenesis, history and treatment of the synovial chondromatosis. The patient has been free of complaints for the 2 years since the operation.     

Synovial chondromatosis of the metacarpophalangeal joint of the ring finger

Synovial chondromatosis is an uncommon condition, characterized by multinodular cartilagineous proliferation of the joint synovium. There are only a few case reports of synovial chondromatosis involving the hand in the literature. A case of synovial chondromatosis of the ring finger is reported in this paper.     

Synovial chondromatosis of the acromioclavicular joint. A case report

Synovial chondromatosis involving the acromioclavicular joint occurred in a 20-year-old woman. Synovectomy including removal of loose bodies and resection of the distal end of the clavicle relieved symptoms. Synovial chondromatosis is a relatively rare disorder and seems not to have been reported in the acromioclavicular joint.     

Synovial chondromatosis of the hand: Three case reports and literature review

Synovial chondromatosis is a rare condition that is probably caused by synovial connective tissue metaplasia. It is very rare in the hand and wrist and because of its low prevalence and nonspecific symptoms, synovial chondromatosis can present diagnostic difficulties for the hand surgeon and may lead to a delay in treatment. We review the literature and report three additional cases of synovial chondromatosis in the hand.     

Synovial chondromatosis of the foot: Two case reports and literature review

BACKGROUND Primary synovial chondromatosis(PSC) is a rare arthropathy of the synovial joints characterized by the formation of cartilaginous nodules, which may detach and become loose bodies within the joint and may undergo secondary proliferation. PSC of the foot and ankle is exceedingly rare, with only a few cases reported in the literature. The diagnosis may be difficult and delayed until operative treatment, when it is confirmed by histological assessment. PSC may degenerate into chondrosarcoma. Operative treatment is the gold standard aiming to minimize pain, improve function, prevent or limit progression of arthritis. Surgical treatment consists in debridement by arthrotomic or arthroscopic management, but there is no consensus in the literature about timing of surgery and surgical technique. Thus, the aim of this study is to report the outcomes of the surgical treatment of two cases, together with a literature review.CASE SUMMARY We report two cases of patients affected by PSC of the foot in stage III, according to the Milgram classification: the former PSC localized in the ankle that underwent open surgery consisted of loose bodies removal; the latter in the subtalar joint, and the choice of treatment was the arthrotomy and debridement from loose bodies, in addition to the subtalar arthrodesis. Both patients returned to complete daily and working life after surgery.CONCLUSION Synovial chondromatosis is a rare benign pathology, even rarer in the ankle joint and especially in the foot. Surgery should be minimal in patients with ankle PSC,choosing the correct timing, waiting if possible until stage III. More aggressive and early surgery should be performed in patients with PSC of the foot,particularly the subtalar joint, due to the high risk of arthritic evolution.     

Complex fracture-dislocation of a fifth metacarpophalangeal joint: case report and literature review

An uncommon complex fracture-dislocation of the fifth metacarpophalangeal joint with an unusually important fracture component is presented. The injury was successfully treated by a combination of open reduction exposing the entrapping structures and percutaneous pin fixation. The case demonstrated the classic pathomechanics as described by Kaplan in 1957. The widened joint space and interposed sesamoid as described by Nutter in 1940 were seen on radiographs.     

Open metacarpophalangeal dislocations: literature review and case report

BackgroundOpen dorsal metacarpophalangeal joint dislocations are rare. We report the case of a 62-year-old man who fell from a height of 10 m onto his left outstretched hand and presented to us with four open dorsal metacarpophalangeal joint dislocations. We review the literature and present our case to elucidate the best treatment protocol for open dorsal metacarpophalangeal joint dislocations.MethodsA systematic review was conducted using MEDLINE, Embase, and PubMed from 1946 to present. Publications were found using key terms and cross-referencing. Detail on patient demographic, presentation, mechanism of injury, injury management, and outcome were collected.ResultsA total of 102 articles of metacarpophalangeal joint dislocation (excluding thumb dislocations) were identified. Of these, only four were of open dorsal metacarpophalangeal joint dislocation involving the four long fingers. Open dislocation of the metacarpophalangeal joint in these studies showed no hand predominance, nor association with hand dominance.ConclusionOpen dorsal metacarpophalangeal joint dislocations of the four long fingers are unusual. Based on the available case reports and our experience, we suggest addressing this injury intraoperatively with minimal delay. Most cases will be associated with volar plate injury, and we encourage its repair with figure-of-eight stitches. Postoperatively, we suggest a dorsal blocking splint for 2 weeks followed by occupational therapy consisting of passive and active range of motion (ROM) exercises and adjunctive therapies to control edema and optimize scar tissue. Inadequate management of such injuries could be highly detrimental to hand function.

Electronic supplementary material

The online version of this article (doi:10.1007/s11552-014-9646-6) contains supplementary material, which is available to authorized users.     

膝关节滑膜软骨瘤病合并股骨骨折1例

滑膜软骨瘤病（synovial chondromatosis）是一种少见关节滑膜疾患，好发于膝、髋、肘等全身大关节，其中以膝关节发病率最高。我院收治一位病史长达30年且合并病理性骨折的患者，国内报道较少，现报告如下。     

Synovial chondromatosis of the shoulder: A case report

Synovial chondromatosis is a rare disease in which cartilaginous masses form in the synovial membrane. The cartilaginous foci may detach to form loose bodies within the joint, which may calcify or ossify. This condition is commonly seen in the knee, hip, or elbow, but is rare in the shoulder (Varma & Ramakrishna 1976, Volpin et al. 1980, Leo & Nocera 1985).     

Recurrent synovial chondromatosis of the wrist: case report and literature review

Synovial chondromatosis of the wrist is rare. We report the case of a 35-year-old man with synovial chondromatosis of the left wrist with an 8-year follow-up. Frequent recurrences finally resulted in total wrist arthrodesis. A review of the literature produced 24 case reports of synovial chondromatosis of the wrist with only three cases showing recurrence.     

Volar dislocation of the first metacarpophalangeal joint. A case report and review of the literature

After suffering traumatic volar dislocation of the first metacarpophalangeal joint, a 27-year-old patient was treated using closed reduction of the thumb. The patient regained full function and stability of the joint after 5 months. A review of the literature indicates that open reduction is the most common treatment for volar dislocation, but our case report suggests that conservative treatment using closed reduction can be highly effective.