Abstract
Primary synovial chondromatosis represents an uncommon benign neoplastic process with hyaline cartilage nodules in the synovial tissue of a joint tendon sheath or bursa. The nodules may enlarge and detach from the synovium. These loose bodies are responsible for many clinical symptoms. Numerous data is available about the synovial chondromatosis of the knee joint, followed by the hip and ankle. Although much has been written about synovial chondromatosis of the large joints, only few case reports of synovial chondromatosis of the spine reported in the English literature and there is no data at all in Russian medical literature [1,2]. Although synovial chondromatosis is generally considered to be benign, cases of condrosarcoma arising from synovial chondromatosis have been reported [3,4]. Synovial chondromatosis should be considered in the differential diagnosis when evaluating additional mass in epidural or paraspinal tissue adjacent to the facet joint, especially when there is evidence of bone erosion. Fluid or myxoid signal centrally with thin or nodular peripheral enhancement is also very characteristic. Compression on bone and nerves is caused by calcified loose or attached to synovium bodies.
Highlights
Primary synovial chondromatosis represents an uncommon benign neoplastic process with hyaline cartilage nodules in the synovial tissue of a joint tendon sheath or bursa
Discrete clusters of hyaline cartilage without evident cytologic atypia of chondrocytes were very characteristic for synovial chondromatosis
Chondrocytes within cartilaginous myxoid matrix showed some occasional plump morphology and pleomorphism. All those features were more consistent with late phase of the development of synovial chondromatosis [7] (Figures 3-7)
Summary
Primary synovial chondromatosis represents an uncommon benign neoplastic process with hyaline cartilage nodules in the synovial tissue of a joint tendon sheath or bursa. The nodules may enlarge and detach from the synovium These loose bodies are responsible for many clinical symptoms. Synovial chondromatosis should be considered in the differential diagnosis when evaluating additional mass in epidural or paraspinal tissue adjacent to the facet joint, especially when there is evidence of bone erosion. CT and MRI images (Figures 1 & 2) demonstrate a heterogeneous mass centered on left L5-S1 facet joint with epidural extension and posterior paraspinal component. CT images show a few faint punctuate calcifications within a predominantly non-calcified mass causing chronic smooth erosion of left posterior cortex of the L5 vertebral body, left L5 pedicle, anterior and posterior surface of left L5-S1 facet joint.
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