An unusual presentation of synovial chondromatosis of the knee in a 10-year-old girl

Synovial chondromatosis commonly occurs in the anterior compartment of the knee joint, predominantly in middle-aged men. It is relatively unusual in female children and is rarely encountered in the synovium beneath the meniscus. The present report describes a rare case of synovial chondromatosis that developed in the synovium just inferior to both menisci of the right knee in a 10-year-old girl. At this unusual age and location, there is a greater probability of missed diagnosis, due to the lack of definite informative incidence, and difficulty in finding the lesions during arthroscopic examinations. In the present case, multiple loose bodies were hidden by the meniscus, and thus, there were no structural abnormalities in the initial arthroscopic views before probing the meniscus. After careful inspection, we found numerous cartilaginous loose bodies and removed them as much as possible with arthroscopy.     

Recurrence of synovial chondromatosis of the glenohumeral joint after arthroscopic treatment

A case of primary synovial chondromatosis of the shoulder in a 15-year-old girl is presented. Plain radiographs revealed findings characteristic of synovial chondromatosis. The patient was treated by arthroscopic loose body removal and arthroscopic partial synovectomy of the glenohumeral joint. Although immediate postoperative radiographs showed no calcification in the joint, repeated radiographs at 18 months after surgery revealed recurrence of calcification in the subacromial space. Arthroscopic removal of all loose bodies and partial synovectomy appears to be a good method of giving symptomatic relief and early return to work. However, late recurrence should be anticipated.     

Synovial chondromatosis of the elbow in a child

Synovial chondromatosis is cartilaginous metaplasia of mesenchymal remnants of synovial tissue of the joints. Its main characteristic is the formation of cartilaginous nodules in the synovium and inside the articular space (loose bodies). It usually presents between the third and fifth decades and is rare in children. It presents as a mono-articular pathology affecting large joints such as the knee, hip, and elbow. The main symptoms are pain, swelling, and limitation of movements in the affected joint. Diagnosis is made by panoramic radiographs, computed tomography scan, and mainly magnetic resonance imaging and on surgery. The authors describe of synovial chondromatosis presenting in the elbow of an 11 year-old girl which is unreported to the best of our knowledge.     

Synovial chondromatosis of the metacarpophalangeal joint: case report and review of the literature

Intra-articular synovial chondromatosis in the hand is rare but should be considered in the differential diagnosis of a swollen, stiff or painful joint. Other possible diagnoses include osteoarthritis, rheumatoid arthritis, gout, trauma and chronic infection, and unless enchondral ossification of loose bodies is seen the diagnosis of synovial chondromatosis may not be made preoperatively. A 69-year-old man with synovial chondromatosis of the metacarpophalangeal joint is reported. The joint was swollen and tender. He had not sustained trauma and there was no evidence of arthritis, involvement of other joints or infection. Complete synovectomy with removal of all loose bodies was successful and his symptoms resolved. Intra-articular synovial chondromatosis is a benign condition, but spontaneous resolution is the exception and surgical synovectomy remains the most effective treatment.     

Stones around bones! atypical giant synovial chondromatosis: a rare case report

We report a case of a 56-year-old man with painless synovial chondromatosis presenting as extremely large masses with smooth surfaces at the suprapatellar region on both side related to the right knee joint. The large masses at the suprapatellar region both in the medial and in the lateral aspect of the knee along with restriction of movements were the main complaints reported by the patient. Plain X-ray studies revealed punctate calcifications anteriorly and on both sides of the knee joint. Surgery was performed subsequently which showed multiple rocky hard giant chondroid masses around the knee without any nodularity. Synovial chondromatosis usually present with small nodular masses, but in our case the masses were very large and had smooth surfaces which were very unusual. After 6 months following the surgery, the patient had full range of motion and no complaints. We suggest that synovial chondromatosis may present as huge masses with smooth surfaces which can mimic as tumors. The Surgeon should be aware of this pattern of appearance of synovial chondromatosis.     

Giant synovial osteochondromatosis of the acromio-clavicular joint in a child. A case report and review of the literature

Primary intra-articular synovial chondromatosis represents an uncommon condition involving mainly the large joints predominantly of middle-aged adults. We herein document the first case of synovial chondromatosis affecting the acromio-clavicular joint of a 10-year-old girl, characterized by a solitary huge intra-articular osteochondromatous body (giant synovial chondromatosis) that had caused dislocation and deformation of the lateral portion of the clavicle. Successful surgical treatment consisted of removal of the osteochondral body and replacement of the clavicle by fixation with a K-wire.     

关节镜下诊断与治疗滑膜软骨瘤病

目的：探讨关节滑膜软骨瘤病在关节镜下的表现、诊断要点、治疗及疗效分析。方法：本组24例,共26个关节,其中膝关节23个,肘关节2个,踝关节1个;男17例,女7例,男女比例2．4：1;年龄18－73岁,平均53岁。均行关节镜检查镜下软骨瘤取出及病变滑膜切除,并描述了该病在关节镜下的表现形式（滑膜表面型;滑膜层包裹型;关节囊纤维层包裹型;游离体型）和处理方法。结果：22例24个关节获得了平均24．5个月随访,未见复发,关节功能均好于术前,效果满意。仅有2例遗漏了2个游离体,无其它并发症。结论：关节镜下游离体摘除和滑膜切除术是治疗滑膜软骨瘤病的良好方法。     

关节镜下诊断与治疗膝关节滑膜软骨瘤病

目的 报道膝关节滑膜软骨瘤病１５例,均用关节镜诊断及治疗,所有病例均经病理检查证实。作者对关节镜在术本病诊断中的优点,分型及治疗方法进行探讨,方法 所有１５例病例均为膝关节病变,左膝关节６例,右膝关节７例,双侧膝关节２例。主要临床症状为关节疼痛,交锁及反复肿胀,关节镜术野好,可全面检查关节腔,具有放大作用,可提高本病的诊断率并有助于分型,关节镜下可将本病分为三型,表浅型,深在型和游离体型,治疗采用     

New-Onset Synovial Chondromatosis After Total Knee Arthroplasty

Total joint arthroplasty is commonly recommended as a definitive treatment for synovial chondromatosis refractory to other treatment. We describe a unique case of synovial chondromatosis developing after total joint arthroplasty in a patient presenting 5 years after total knee arthroplasty for osteoarthritis. This case illustrates that the diagnosis of synovial chondromatosis cannot be excluded in a patient with chronic, painful swelling of a joint, even after total joint arthroplasty.     

Arthroscopic Retrieval of over 100 Loose Bodies in Shoulder Synovial Chondromatosis: A Case Report and Review of Literature

Synovial chondromatosis is a rare and benign condition of unknown cause. It is also known as synovial osteochondromatosis. It is characterized by involvement of the synovial tissue, which lines various joints of our body. Initial symptoms range from pain in the joint, locking of the joint at times, especially the knee, to arthritis of the joint that is a late feature of this condition. Although large joints such as the knee are commonly affected, involvement of the shoulder joint is a rare occurrence. Historically an open arthrotomy was preferred for removal of loose bodies coupled with a thorough synovectomy. However, arthroscopy for loose body retrieval has gained popularity over the past two decades. Arthroscopic surgery is an extremely skilled procedure and there is a learning curve for operating in certain anatomical areas such as the shoulder. However, not only does an arthroscopy provide the surgeon with an excellent view of the shoulder but the patient also has a faster recovery. We report a rare case of shoulder synovial chondromatosis in which more than 100 loose bodies were successfully retrieved by an arthroscopy in an individual who had an excellent outcome post‐surgery, reaffirming our faith in the procedure. A detailed literature review of arthroscopic procedures is also presented.     

Diagnosis and Arthroscopic Treatment of Primary Synovial Chondromatosis of the Shoulder

Primary synovial chondromatosis of the shoulder is a rare condition. We present the case of a 24-year-old man with a 6-month history of right shoulder pain and decreased range of motion. Computed tomography and magnetic resonance imaging findings led us to the diagnosis of synovial chondromatosis of the shoulder. Arthroscopy revealed loose bodies in the glenohumeral joint, the biceps tendon sheath, and the subscapularis recess. Active intrasynovial proliferation of the axillary pouch was noted. All loose bodies were removed arthroscopically, and partial synovectomy was performed. Histologic examination confirmed the diagnosis of primary synovial chondromatosis. We recommend arthroscopic treatment for synovial chondromatosis of the shoulder because of low morbidity and early functional return.     

Synovial chondromatosis of the acromioclavicular joint

Summary Synovial chondromatosis involving the acromioclavicular joint is very rare. We report a case of synovial chondromatosis of the acromioclavicular joint associated with synovial cyst formation. Arthrography of the acromioclavicular joint revealed that the loose bodies lay within a synovial cyst which was in communication with the acromioclavicular joint. Synovectomy including removal of the synovial cyst and the loose bodies relieved symptoms completely. The patient was still pain- and recurrence-free at 4 years' follow-up.     

Results of total hip and total knee arthroplasties in patients with synovial chondromatosis

This retrospective analysis examines the outcome of total joint arthroplasty for severe arthritis in patients with synovial chondromatosis. All 11 patients treated with total hip arthroplasty (n = 7) or total knee arthroplasty (n = 4) returned for follow-up at a mean of 10.8 years after surgery. Pain and functional scores improved significantly in all patients. Knee range of motion improved in all patients. Synovial chondromatosis recurred in 1 knee (25%) and 1 hip (14%). Total joint arthroplasty is a valuable treatment option for these patients with predictable improvement in pain and function. Knee range of motion is likely to improve but may be less than expected for primary total knee arthroplasty. Patients remain at risk for recurrence.     

Arthroscopic treatment of synovial chondromatosis of the ankle

A 34-year-old male soccer player with chronic right ankle dysfunction and a history of repeated ankle joint injuries is presented. Imaging studies revealed synovial chondromatosis of the ankle joint. Arthroscopic partial synovectomy was performed and more than 20 loose bodies were excised. Four months postoperatively the patient was asymptomatic and has returned to his previous level of sport activities. At the latest follow-up, 2 years after the initial diagnosis there is no local recurrence of the disease. Arthroscopy is a minimal invasive surgical technique, with satisfactory results in the treatment of synovial chondromatosis of the ankle joint.     

Synovial Chondrosarcoma Arising in Synovial Chondromatosis of the Temporomandibular Joint

Synovial chondromatosis of the temporomandibular joint is rare. Even less commonly documented is the progression of synovial chondromatosis to a synovial chondrosarcoma. The aim of this paper is to present only the third case of synovial chondrosarcoma of the temporomandibular joint. Distinction between these two entities by histology alone is extremely difficult and even though it is advised that the definitive diagnosis should be based on clinical, radiographic and histological evidence, this has proved not to be so simple. The patient, a 63 year old female presented with a swelling associated with her left temporomandibular joint. CT and MRI scans confirmed the presence of a periauricular chondroid mass. Fine needle aspiration biopsy revealed an atypical chondroid lesion that was supicious for a chondrosarcoma. The left temporomandibular joint and surrounding tissues were resected after further imaging and extensive clinical, radiological and cytologic consultations. A diagnosis of synovial chondrosarcoma arising in synovial chondromatosis was made.     

Synoviale Chondromatose

Primary articular synovial chondromatosis is a benign, self-limiting neoplastic process in which hyaline cartilage nodules form in the synovial tissue. The disease most frequently affects the knee in men, followed by the elbow. The basic feature of this disease is a metaplastic maturation of the mesenchymal cells in the synovial membrane of a joint into cartilage. These cells mature into chondroblasts and form small nodules of cartilage in the synovial membrane. These nodules subsequently enlarge and detach to lie within the joint space. They become free within the joint as multiple small cartilaginous loose bodies nourished by the synovial fluid. The chondrocytes in the loose bodies continue to multiply, and the loose bodies grow in diameter. Calcification appears in the central zone of the loose bodies, and in some cases, enchondral ossification takes place. The operative therapy depends on the stage of the disease: synovectomy with removal of chondral fragments if active intrasynovial disease is present, and removal of the multiple chondral bodies alone in cases of late inactive disease with no synovial abnormalities. Malignant transformation is unusual and can be difficult to distinguish from benign disease.     

Synovial chondromatosis of the knee joint]

Authors removed more than hundred free bodies from the knee joint of a young female patient. In connection with their case the criteria of the synovial chondromatosis, the theories concerning the pathogenesis and the therapy to be chosen are described, based on literary data.     

Synovial chondromatosis in a facet joint of a cervical vertebra

STUDY DESIGN: A case report of a cervical facet joint synovial chondromatosis. OBJECTIVES: To correlate the radiologic and histologic features of vertebral synovial chondromatosis with review of the literature. SUMMARY OF BACKGROUND DATA: Only two previous cases of vertebral facet joint synovial chondromatosis were found in a review of the English language medical literature. METHODS: A 39-year-old woman had severe cervical pain associated with neurologic signs and symptoms in the left upper extremity. Computed tomographic and magnetic resonance imaging studies were performed. RESULTS: Imaging studies showed lytic defects in the laminae of C3 and C4, with intermediate T1 and high T2 signal intensities. The diagnostic impression was that of a lymphangioma or synovial cyst. A laminectomy showed synovial tissue in both the C3-C4 facet joint and the lamina bone. Histologic examination disclosed synovial chondromatosis. CONCLUSIONS: Synovial chondromatosis of the vertebral spine is quite rare, this being only the third reported example. Direct invasion of the cancellous bone, as in this case, also is a very uncommon feature of chondromatosis. It is emphasized that when radiologic studies demonstrate a lesion with cartilaginous characteristics within or juxtaposed to a joint, synovial chondromatosis, despite its rarity, should be included in the differential diagnosis, regardless of the anatomic site.     

Synovial Chondromatosis of the Temporomandibular Joint Successfully Treated by Surgery

Synovial chondromatosis (SC) is a chronic process, defined as a reactive cartilaginous proliferation, characterized by formation of cartilaginous nodules, usually loose in the joint space of the synovial membrane. It mainly affects large joints such as knee, hip, shoulder, and elbow, commonly in male patients. However, its manifestation in the Temporomandibular joint (TMJ), is a rare finding, occurring predominantly in females. This paper reports a case of a woman who presented to the service of Stomatology complaining of mouth opening limitations and pain in her left pre-auricular region. After clinical and radiographic analyses, the condition was diagnosed as SC of the TMJ. The loose bodies within the TMJ were removed under general anesthesia. Histological and follow-up features of this lesion are also discussed. To our knowledge, this is the second report of SC of the TMJ in Brazil.     

髋关节原发性滑膜软骨瘤病的诊断与治疗

目的 探讨髋关节原发性滑膜软骨瘤病的早期诊断与手术疗效。方法 5例髋关节原发性滑膜软骨瘤病患者,左侧2例,右侧3例,采用髋关节后外侧入路加大转子截骨入路显露髋关节,其中4例行单纯游离体摘除术,1例行病变滑膜切切除加游离体摘除术。结果 随访时间6-36个月,平均18个月。治愈3例,好转1例,未愈1例。结论 该病早期诊断困难,临床、放射学及病理检查相结合是确诊关键;采用髋关节后外侧入路加大转子截骨显露术摘除游离体、切除病变滑膜,疗效确切。