Locking wrist with synovial chondromatosis: Report of two cases

Abstract

A 60-year-old farmer presented with the complaint that for approximately 1 year his right wrist sometimes locked with pain when he lifted a heavy object. There was no history of injury. Physical examination showed swelling of the dorsal aspect of the distal radioulnar joint with local tenderness. The wrist had a full range of motion. X-ray films demonstrated three radiopaque bodies lying in the distal radioulnar joint (Fig. I), with the distal one lodged in the radiolunate joint when the wrist locked (Fig. 2). At surgery. the synovium and all chondral bodies were excised (Fig. 3). The triangular fibrocartilage was torn at the ulnopalmar margin, and this was repaired. The wrist locking was probably due to the free body that was displaced from the distal radioulnar joint through the torn triangular fibrocartilage into the radiocarpal joint. Microscopically, the synovium was characterized by the presence of multiple nodular cartilaginous bodies. After 2 weeks of cast immobilization, the patient was pain-free without locking or limitation of wrist motion.