Clinical Case Vignettes

Synovial chondromatosis

Yathish GC1, Canchi Balakrishnan2, Mangat Gurmeet2, Taral Parikh1, Sagdeo Parikshit1, Parmar Alpana1

 

Author Affiliations

1Resident in Rheumatology, P.D Hinduja Hospital and Research Centre, Mumbai

2Consultant Rheumatologist,P.D Hinduja Hospital and Research Centre, Mumbai

 

*Correspondence: Dr.Yathish GC

yathish_gc@yahoo.co.in

 

IJRCI. 2015;3(1):V2

 

Received: 21 February 2015, Accepted: 24 February 2015, Published: 27 February 2015

 

© IJRCI

 

Synovial chondromatosis is characterized by foci of cartilage in the synovial membrane of joints, bursae or tendon sheaths, as a result of metaplasia of the subsynovial connective tissue. These ectopic foci of cartilage can cause painful joint effusions, the generation of loose bodies, and mechanical symptoms.1-3 Synovial chondromatosis occurs in primary and secondary forms. Primary disease involves the presence of ectopic cartilage in synovial tissue as loose bodies in the joint cavity, without an identifiable joint pathology. Secondary synovial chondromatosis is more common than primary disease. It occurs in patients with pre-existing osteoarthritis, rheumatoid arthritis, osteonecrosis, osteochondritis dissecans, neuropathic osteoarthropathy, tuberculosis, or osteochondral fractures. Free chondral or osteochondral fragments, formed by underlying disease implant, induce the formation of metaplastic cartilages around them. The free bodies are typically larger and of more varied sizes than those seen in primary disease.4  The figure 1 indicates the presence of bilateral, multiple synovial osteochondromatosis in a patient with knee osteoarthritis, with more disease on the right side.

 

Fig. 1a: Lateral view of multiple synovial osteochondromatosis in a patient with knee osteoarthritis, 1b: AP view of right knee

 

 

Competing interests

The authors declare that they have no competing interests.

 

References

1.     Kirchhoff C, Buhmann S, Braunstein V, Weiler V, Mutschler W, Biberthaler P. Synovial chondromatosis of the long biceps tendon sheath in a child: a case report and review of the literature. J Shoulder Elbow Surg. May-Jun 2008;17(3).

2.     Adelani MA, Wupperman RM, Holt GE. Benign synovial disorders. J Am Acad Orthop Surg. May 2008;16(5):268-75.

3.     Fuerst M, Zustin J, Lohmann C, Rüther W. [Synovial chondromatosis]. Orthopade. Jun 2009;38(6):511-9.

4.     Wodajo F, Gannon F, Murphey M. Synovial Chondromatosis. In: Visual Guide to Musculoskeletal Tumors: A Clinical – Radiologic – Histologic Approach. Philadelphia: Saunders; 2010.