Abstract
Background:Synovial chondromatosis is characterized by cartilaginous metaplasia in synovial tissues. Extra-articular tenosynovial chondromatosis is considered to be an anatomical counterpart of articular synovial chondromatosis. Extra-articular tenosynovial chondromatosis occurs preferentially in the hand, although its frequency is low.Results:We report three cases of extra-articular tenosynovial chondromatosis. A 65-year-old female presented with a history of symptoms over 40 years related to the dorsum of her index finger (Case 1), A 46-year-old female presented with a 6-month history of symptoms at the volar surface of her middle finger (Case 2), and a 66-year-old male presented with a 3-month history of symptoms in a dorsal ring finger. Case 2 had evidence of ossification, which could be classified as osteochondromatosis. Interestingly, the index finger lesions (Case 1) were accompanied by excessive bone involvement. The signal intensity of T2-weighted magnetic resonance imaging varies from low to high, possibly reflecting histological variations, such as ossification and fatty tissue changes. All lesions were resected without complications.Conclusion:Variations in anatomical sites suggest that overuse or mechanical overloading was not causative. Extensive involvement of the nearby tendon and joint capsule, as well as the bone, would require attention during the resection. Preoperative analysis of images is important, not only for the diagnosis, but also to assess the extent of the lesion, particularly given the complex anatomy of the finger.
Highlights
Synovial chondromatosis is an unusual condition that is characterized by cartilaginous metaplasia in the synovial membrane of joints, bursae, and tendon sheaths [1 - 3]
We report three cases of extra-articular tenosynovial chondromatosis of the finger, using each case to characterize the clinical features of the associated pathology, and we present radiologic and histologic findings
The 65-year-old patient who had a 40-year history of extra-articular tenosynovial chondromatosis suggests that the initial symptoms can occur at approximately 20 years old, or at any adult age
Summary
Synovial chondromatosis is an unusual condition that is characterized by cartilaginous metaplasia in the synovial membrane of joints, bursae, and tendon sheaths [1 - 3]. Articular synovial chondromatosis typically involves large joints such as the knee and the hip [4, 5]. Extra-articular tenosynovial chondromatosis is considered to be an anatomical counterpart of articular synovial chondromatosis, and tends to occur in the hands and feet [6 - 8]. Extra-articular tenosynovial chondromatosis of the finger is a rare condition. Signs and symptoms include swelling, 1874-3250/17 2017 Bentham Open. 418 The Open Orthopaedics Journal, 2017, Volume 11 reduced range of motion, and pain [6]. Extra-articular tenosynovial chondromatosis is considered to be an anatomical counterpart of articular synovial chondromatosis. Extra-articular tenosynovial chondromatosis occurs preferentially in the hand, its frequency is low
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