Synovial Chondromatosis of the Radiocarpal Joint

Abstract

Synovial chondromatosis is an uncommon lesion of unknown etiology, characterized by progressive metaplasia associated with the formation of cartilage in the synovial membranes of joints, tendon sheaths, or bursae. Synovial chondromatosis is typically monoarticular and affects large joints such as the knee and hip, although it has also been described in the ankle, elbow, and shoulder. However, it rarely occurs in the wrist. Our literature review showed only 28 cases with wrist involvement, 13 cases with distal radioulnar joint involvement, 12 cases with midcarpal joint involvement, and 3 cases with radiocarpal joint involvement. This article presents a case of synovial chondromatosis of the radiocarpal joint. A 45-year-old right-handed woman presented with a 4-year history of a palpable mass and pain in her right wrist. On physical examination, 2 masses were palpable on the volar and radial aspect of the joint. Plain radiographs of the right wrist demonstrated well-defined radiopaque calcified mass lesions. Cortex and subcortical bone on the radial aspects of the radius and scaphoid were eroded. T1-weighted magnetic resonance imaging (MRI) showed a low-signal-intensity lesion, and T2-weighted MRI showed a heterogeneous high-signal-intensity lesion in the radiocarpal joint, which was consistent with synovial chondromatosis. Operatively, 2 glistening white lobulated masses were removed together with attached synovia. A histologic examination confirmed synovial chondromatosis with dystrophic calcification. At the time of the most recent examination (3 years postoperatively), the patient was pain-free, had no residual motion deficit, and showed no radiographic evidence of recurrent disease.