Chondromatosis Research Articles

Synovial Chondromatosis of Distal Radioulnar Joint with Osteoarthropathic Changes

Abstract Objective Synovial chondromatosis (SC) is relatively rare, but it often occurs in large joints and can cause osteoarthropathic (OA) changes if left untreated. It is extremely rare for this condition to occur around the wrist joint. We present a case treated by osteophyte resection for restriction of the forearm rotation caused by SC and the resulting OA changes in the distal radioulnar joint (DRUJ). Case Description A 50-year-old woman had progressive OA changes due to SC in the DRUJ, and restriction of forearm rotation. Thorough excision of SC and osteophytes through the dorsal and palmar approaches of the wrist improved the range of rotation of the forearm with no recurrence. Literature Review Although there have been scattered reports of SC occurring in the DRUJ, there have been no reports of management for restriction of forearm rotation caused by OA changes. Clinical Relevance For SC in DRUJ, it is important to make an early definitive diagnosis and perform a synovectomy to prevent the progression of OA changes. Osteophyte resection is effective in the treatment of restriction of the joint motion caused by secondary OA changes.

Synchronous Primary Synovial Chondromatosis of the Hip: An Integrated Perspective on Physiotherapeutic Support.

Primary synovial chondromatosis of the hip is a rare joint condition characterized by the abnormal proliferation of cartilaginous tissue within the synovial membrane, which leads to the formation of clusters of chondrocytes floating in the joint space. This commentary provides a comprehensive overview of the pathology, including symptoms, diagnosis, treatment options and long-term management. Patients with primary synovial chondromatosis complaint pain and functional impairment, together with a peculiar joint popping sensation during movement, so determining early disability. The early treatment can lead to better clinical outcomes, with increased preservation of joint function and reduced risk of long-term disability, but strictly depend on symptoms acknowledgement and proper imaging interpretation. As a chronic pathology, surgical approach must necessarily be part of a larger medical and rehabilitative care planning, with long period follow-up. Multidisciplinary team management, with the active involvement of the patient is pivotal in improving the clinical outcomes and quality of life.

Primary Synovial Chondromatosis of the Knee in a 12-Year-Old Boy: A Case Report

Primary Synovial Chondromatosis of the Knee in a 12-Year-Old Boy: A Case Report

A rare case of synovial chondromatosis of the foot

Background: Synovial chondromatosis is a benign rare condition affecting synovial tissue. It has a preference for males with a ratio of 2:1. Also, synovial chondromatosis has a prevalence of 1 in 100,000. Initially, it starts asymptomatically then develops pain, and swelling with or without a restricted range of motion as the disease progresses. In addition, the imaging options are an x-ray and then an MRI. To confirm the diagnosis, a biopsy with histopathologic evaluation is needed. Finally, conservative management options are NSAIDs and intraarticular steroids. Surgery is considered after the failure of conservative management. Case Presentation: A case of synovial chondromatosis of the left foot in a 37-year-old female with no prior medical or surgical history was presented. The patient came with no signs or symptoms and was admitted as a case of elective mass excision. Histopathologic evaluation of the mass confirmed the diagnosis of synovial chondromatosis. Initially, perioperative spinal anesthesia was performed. After the patient had been sedated, a vertical incision directly over the dorsolateral aspect of the foot, over the lesion, was made. Subsequently, a lateral incision and a midline horizontal incision at a 90-degree angle to the initial surgical incision were made. Finally, the mass was excised completely with no remnants. Conclusion: Synovial chondromatosis is a frequently sub-diagnosed disease and has not been fully understood, so proper clinical evaluation ought to be done earlier for better outcomes.

Radiological Study of Synovial Chondromatosis of the Temporomandibular Joint

Abstract Temporomandibular joint disorders (TMDs) are usually accompanied by changes in the bone structure of the TMJ brought on by degenerative processes. Osteophytes, erosion, flattening, subchondral sclerosis, pseudocysts, TMJ remodeling, articular cartilage abrasion, bone degradation, and synovial inflammation are among the characteristics of degenerative joint disease. Synovial chondromatosis (SC) is one of the degenerative joint conditions, which is defined by the growth of cartilaginous nodules, which are typically loose in the joint space of the synovial membrane. Its appearance in the TMJ, however, is more uncommon than in other large joints such as the knee and hip and is accompanied by preauricular pain, swelling, and restricted mouth opening. However, we recently encountered cases of degenerative joint disorder, i.e., of SC of TMJ, which showed the typical histopathological findings along with the typical imaging findings on Panoramic radiography (PAN) TMJ and cone-beam computed tomography images.

Unusual Etiology of shoulder pain: A rare case report of synovial chondromatosis managed arthroscopically

Unusual Etiology of shoulder pain: A rare case report of synovial chondromatosis managed arthroscopically

Synovial Chondromatosis of Shoulder Treated by Arthroscopic Synovectomy and Removal of Loose Bodies: A Case Report

Synovial Chondromatosis of the shoulder is mentioned in literature as a rare case. It is a benign neoplastic condition of the synovial membrane. Multiple osteocartilaginous loose bodies inside the joint characterize this rare monoarticular disorder. This case report describes a 32-year-old man who presented with right shoulder pain for six months. He had painful abduction and internal rotation. The condition was diagnosed as synovial chondromatosis. The patient underwent arthroscopic removal of loose bodies and synovectomy. This case illustrates the investigation and treatment of synovial chondromatosis of the shoulder. The loose bodies in synovial chondromatosis of a shoulder joint can be retrieved by arthroscopy as it provides a broader field of vision, better accessible access to the loose bodies, synovectomy, reduced hospital stay, and better rehabilitation. Keywords: Arthroscopy, Loose Bodies, Shoulder, Synovial Chondromatosis

COL3A1 is a potential diagnostic biomarker for synovial chondromatosis and affects the cell cycle and migration of chondrocytes

BackgroundSynovial chondromatosis (SC) primarily affects the major joints and is characterized by the formation of benign cartilaginous nodules. In the present study, we evaluated the differences in the histology and gene expression of SC and normal cartilages and further elucidated the function of hub genes in SC. MethodsHistological staining and biochemical analysis were performed to measure collagen and glycosaminoglycan (GAG) contents in SC and normal cartilage samples. Then, microarray analysis was performed using knee joint samples (three normal and three SC samples) to identify the differentially expressed genes (DEGs). Subsequently, bioinformatics analysis was performed to identify the hub genes and explore the mechanisms underlying SC. The intersection of the top 10 upregulated DEGs, top 10 downregulated DEGs, and hub genes was validated in SC tissues. Lastly, in vitro experiments and our clinical cohort were used to determine the potential biological functions and diagnostic value, respectively, of the most significant gene. ResultsThe GAG and collagen contents were comparable to or higher in SC tissues than in normal tissues. Microarray analysis revealed 143 upregulated and 107 downregulated DEGs in SC. Furthermore, functional enrichment analysis revealed an association between immunity and metabolism-related pathways and SC development. Among 20 hub genes, two intersection genes, namely, collagen type III alpha 1 chain (COL3A1) and HSPA8, were notably expressed in SC tissues, with COL3A1 exhibiting a more significant difference in mRNA expression. Furthermore, COL3A1 can promote chondrocyte migration and cell cycle progression. Additionally, clinical data revealed COL3A1 can be a diagnostic marker for primary SC (AUC = 0.82) and be a positive correlation with neutrophil-to-lymphocyte ratio. ConclusionsThese results suggest that SC tissues contained the abundant GAG and collagen. COL3A1 can affect the function of chondrocytes and be a diagnostic marker of primary SC patients. These findings provide a novel approach and a fundamental contribution for diagnosis and treatment in SC.

Opinion: the nature of primary and secondary synovial chondromatosis: importance of pathological findings.

Opinion: the nature of primary and secondary synovial chondromatosis: importance of pathological findings.

Primary Synovial Chondromatosis of the Hip: Case Report and Litérature Review

Primary synovial chondromatosis represents an uncommon benign neoplastic process with hyaline cartilage nodules in the subsynovial tissue of a joint, tendon sheath, or bursa. The knee, followed by the hip, in male adults are the most commonly involved sites and patient population. Radiologic findings are frequently pathognomonic. Radiographs reveal. The diagnosis can be made based on imaging alone, starting with radiography. A CT-scan or MRI-scan is indicated if diagnosis remains unclear based on the radiograph or it can be used for preoperative planning. We reported a case of 42 years with primary synovial chondromatosis of the left hip.

Synovial chondromatosis: Rare involvement of metacarpophalangeal joint and diagnostic challenges in MR imaging.

Synovial chondromatosis (SC) is a rare benign tumor of the cartilaginous tissue that frequently affects large joints intra-articularly. Characteristic imaging findings were reported for the diagnosis of SC. Herein, we report a case of SC of the metacarpophalangeal joint with atypical MRI findings. Considering the clinical presentation, erosion, absence of calcification on X-ray and CT, and low intensity on short tau inversion recovery (STIR), tenosynovial giant cell tumor was the initially diagnosis. However, histopathological findings revealed SC with fibrosis, which was confirmed using Elastica Van Gieson (EVG) staining. In general, low intensity on STIR in SC indicate calcification; however, it can also represent fibrosis in SC. In this case, the diagnosis of SC using MRI was limited highlighting the importance of histopathological findings for an accurate diagnosis of SC.

Concomitant Ipsilateral Knee Pain Is Associated With Worse Preoperative Functional Status and Short-Term Outcomes After Hip Arthroscopy in Patients With Femoroacetabular Impingement Syndrome

Purpose(1) To determine the effect of concomitant IKP (ipsilateral knee pain) on short-term outcomes after hip arthroscopic treatment of FAIS (femoroacetabular impingement syndrome), and (2) to determine whether IKP would improve with surgery. MethodsData between September 2021 and May 2022 was reviewed. Patients diagnosed with FAIS and underwent hip arthroscopy with minimum of 1-year follow-up were included. Exclusion criteria were prior ipsilateral hip or knee surgery, hip Tönnis grade > 1, knee Kellgren-Lawrence grade > 2, hip conditions (avascular necrosis, Legg-Calve-Perthes disease, pigmented villonodular synovitis, osteoid osteoma, synovial chondromatosis and developmental dysplasia of the hip), and spine diseases. A knee MRI was performed on all patients preoperatively. Preoperative and short-term (1 year) patient-reported outcome (PRO) scores were collected for Hip Sports Activity Scale (HSAS), weekly sports participation, modified Harris Hip Score (mHHS), international Hip Outcome Tool, 12-component form (iHOT-12), visual analog pain scale (VAS) of the hip and ipsilateral knee. The percentage of achieving minimal clinically important difference (MCID) and patient acceptable symptom state (PASS) of mHHS and iHOT-12 were calculated. Multivariate regression analysis was performed to determine the effect of IKP severity on postoperative outcomes. Subgroup analysis was performed between patients with and without IKP alleviation. ResultsAmong the 107 patients included, 47 presented preoperative IKP. Compared to patients without IKP, the IKP cohort had comparable knee structural abnormalities (all with P > 0.05). Still, it showed inferior preoperative mHHS (P = .003), iHOT-12 (P = .016), hip VAS (P = .001), and weekly sports participation (P = .039). Postoperatively, the IKP cohort had lower mHHS (P = .046), iHOT-12 (P = .037), and hip VAS (P = .003), and were less likely to achieve PASS of mHHS (P = .021) and iHOT-12 (P = .049). Patients with higher knee VAS were less likely to achieve PASS of mHHS (OR = 0.61; P = .023). Within the IKP group, knee VAS improved from 2.3 to 1.0 (P < .001). Those with alleviated IKP showed superior postoperative iHOT-12 (P = .038) compared to those with persistent IKP. ConclusionConcomitant IKP at baseline negatively affected preoperative status and short-term PROs after arthroscopic treatment of FAIS. Patients with IKP were less likely to meet clinical thresholds. Most patients achieved IKP alleviation postoperatively, which was associated with superior clinical outcomes. Level of evidenceIII, retrospective cohort study.

Imaging features of temporomandibular joint synovial chondromatosis with associated osseous degenerative changes

Synovial chondromatosis (SC) of the temporomandibular joint (TMJ) is a rare benign disease associated with the formation of multiple cartilaginous nodules in the synovial tissue of the TMJ. This can result in pain, swelling, clicking, limited mouth opening, and osseous degenerative joint changes. A retrospective cross-sectional study was performed to summarize the clinical features, radiographic findings, and surgical and histopathological findings of TMJ SC patients who underwent open surgery over a 24-year period. A radiographic scoring system was used to evaluate osseous changes and correlate condyle and joint fossa degeneration. The study included 38 patients and focused on 38 joints. All 38 of these joints showed degenerative changes in the condyle, while 37 showed osseous degenerative changes in the articular fossa. The degree of condylar degenerative changes was related to the duration of the chief complaints (r = 0.342, P = 0.036) and the histopathological stage of the TMJ SC (r = 0.440, P = 0.006), while the degree of joint fossa degenerative changes was associated with the radiographic extent of the SC (r = 0.504, P = 0.001), type of calcification (r = 0.365, P = 0.024), and the histopathological stage (r = 0.458, P = 0.004).

Giant Synovial Chondromatosis of the Shoulder: The Limits of Arthroscopic Treatment and Technical Tips

Synovial chondromatosis (SC) is a rare disease. It is a chondrocytic metaplasia and is characterized by the presence of cartilaginous loose bodies in the involved joint, bursa or tendon sheath, it occurs most often in those aged 30_50 years and 3 times more in males than females, The shoulder is an exceptional location. It causes significant functional disability in young people. The clinical presentation is not specific, and the diagnosis is based on MRI. Confirmation is still anatomopathological. Classically, the mainstay treatment for SC of the shoulder has been open arthrotomy and removal of loose bodies, followed by either complete or partial synovectomy, removing the affected tissue, with recent advances in arthroscopic techniques and methods, arthroscopy becomes the gold standard. We present this case report of a 26-year-old man, who was left-hand dominant, a maintenance technician, amateur football player presented a left shoulder inflammatory pain; ; plain radiography demonstrated multiple calcific densities over the glenohumeral joint , the MRI showed multiple calcified intra-articular loose bodies around the anterior and posterior joint and axillary recess ; At arthroscopy, a large number of loose bodies were observed together with marked synovitis ,it only allowed the removal of small foreign bodies &lt; 1 cm, partial synovectomy was performed with a shaver ; anatomopathological examination confirmed the diagnosis of sc. the extraction of giant fragments &gt;2 cm was impossible so it was subsequently removed by open surgery. This was carried out one month later using a delto-pectoral approach: all foreign bodies &gt; 1 cm were successfully extracted. We report this case report in order to review the role of shoulder arthroscopy and magnetic resonance imaging (MRI) in diagnosis and treatment and to highlight the operative difficulties, technical tips of arthroscopic extraction of giant Synovial chondromatosis of the shoulder.

Retrospective study of synovial chondromatosis of the temporomandibular joint: clinical and histopathologic analysis and the early-stage imaging features

Herein, we aimed to study the clinical, radiographical, and histopathologic features of synovial chondromatosis in the temporomandibular joint (SC in TMJ) and provide references for early diagnosis and treatment prognosis. The medical records and imaging examinations of patients with SC in TMJ, diagnosed using postoperative histopathologic examination, were reviewed and analyzed. Among them, 18 cases who lacked calcified loose bodies on spiral computed tomography or cone beam computed tomography (SCT/CBCT) were selected for further study. Descriptive statistical methods were used to analyze the clinical characteristics of patients. The study included 100 patients with SC in TMJ, who were predominantly female (male to female: 1:3), and were aged from 21 to 77 years (median, 47). Radiopaque calcified lesions on SCT/CBCT were missing in 18 cases, but cartilaginous nodules were observed during surgery. The cases lacking calcification had a relatively shorter disease course, suggesting they were in the early stages of SC. In the early stage of SC, although calcified loose bodies cannot be detected on SCT/CBCT, attention should be paid to the widening of the posterior superior joint space and sclerosis or slight erosion of the joint fossa. Magnetic resonance imaging would be helpful to detect the early-stage SC in TMJ.

The Role of Temporomandibular Joint Arthroscopy for Diagnosis and Surgical Management of Synovial Chondromatosis.

We report the experience of our maxillo-facial surgery unit into the diagnostic and the therapeutic role of arthroscopy of temporomandibular joint (TMJ) synovial chondromatosis (SC). A series of sixteen patients with an imaging, arthroscopical, and histological diagnosis of SC treated with arthroscopy was selected. The surgeries were conducted in the Department of Maxillo-facial surgery, Academic hospital of Udine, from January 2016 to December 2022. Medical history, clinical examination, imaging, arthroscopical, and histological characteristics were recorded and then reviewed and discussed. Clinical improvement, both in pain and in maximum incisal opening (MIO), were noticed in whole patients. Histologically, according to Milgram's classification, the sample was fairly homogeneous. Arthroscopic treatment was successful in 87.5% of the patients. Only two cases of SC relapse were registered and were then submitted to open surgery to perform a total sinovectomy. The data collected were used to develop an SC classification proposal based on clinical, radiological (magnetic resonance imaging), arthroscopical, and histopathological characteristics. TMJ arthroscopy must be considered the first line of treatment for SC, leaving open surgery to relapses cases and those cases with extraarticular extension. A univocal classification is essential to best stage and prognostically characterise this pathology.

Differentiation between Chondrosarcoma and Synovial Chondromatosis of the Temporomandibular Joint Using CT and MR Imaging.

Chondrosarcoma and synovial chondromatosis of the temporomandibular joint share overlapping clinical and histopathologic features. We aimed to identify CT and MR imaging features to differentiate chondrosarcoma from synovial chondromatosis of the temporomandibular joint. The CT and MR images of 12 and 35 patients with histopathologically confirmed chondrosarcoma and synovial chondromatosis of the temporomandibular joint, respectively, were retrospectively reviewed. Imaging features including lesion size, center, enhancement, destruction/sclerosis of surrounding bone, infiltration into the tendon of the lateral pterygoid muscle, calcification, periosteal reaction, and osteophyte formation were assessed. A comparison between chondrosarcoma and synovial chondromatosis was performed with a Student t test for quantitative variables and the Fisher exact test or linear-by-linear association test for qualitative variables. Receiver operating characteristic analysis was performed to determine the diagnostic performance for differentiation of chondrosarcoma and synovial chondromatosis based on a composite score obtained by assigning 1 point for each of 9 imaging features. High-risk imaging features for chondrosarcoma were the following: lesion centered on the mandibular condyle, destruction of the mandibular condyle, no destruction/sclerosis of the articular eminence/glenoid fossa, infiltration into the tendon of the lateral pterygoid muscle, absent or stippled calcification, periosteal reaction, internal enhancement, and size of ≥30.5 mm. The best cutoff value to discriminate chondrosarcoma from synovial chondromatosis was the presence of any 4 of these high-risk imaging features, with an area under the curve of 0.986 and an accuracy of 95.8%. CT and MR imaging features can distinguish chondrosarcoma from synovial chondromatosis of the temporomandibular joint with improved diagnostic performance when a subcombination of 9 imaging features is used.

A rare case of extra-synovial and intracapsular ganglion cyst of the knee joint

A 23 year old female presented with knee swelling which was found to be ganglion cyst of the knee with extra synovial and intracapsular origin form the lateral meniscus which was causing pain in extreme extension. The cyst was excised and confirmation was done on histopathology. Ganglion cysts may have following differential diagnoses of ganglion cysts may include synovial chondromatosis, pigmented villonodular synovitis, meniscal or parameniscal cysts, and synovial hemangioma. Which needs good histopathological and radiological correlation. Most common sites of Intra-articular ganglion cysts are in the dorsal wrist, palm, and shoulder but rarely found in the knee joint.

Diagnosis and management of temporomandibular joint synovial chondromatosis: A systematic review

The aim of this study was to systematically review the diagnosis and management of temporomandibular joint synovial chondromatosis (TMJ-SC). Using a systematic study design based on the PRISMA guideline, the researchers implemented and analyzed a cohort of relevant publications indexed by PubMed, Embase, Medline, and LILACS between January 1990 and December 2022. The outcomes of interest were demographics of the primary studies, and Clinical, radiological, and therapeutic data associated with TMJ-SC. The study samples included 8 studies presenting 121 TMJ-SC cases (73.6% female; 100% unilateral; 53.7% left-sided; mean age, 43.3 ± SD 5,80 [range, 21–81]. Non-specific symptoms were mostly reported, including TMJ pain, noise and local inflammation, and/or malocclusion. Radiographically, loose bodies, masses with low-signal foci, and calcification were common charateristics. Until now, there has been no internationally accepted consensus on diagnosis and management of TMJ-SC. Arthroscopic surgery should be performed on masses confined to the superior TMJ space, while open arthroplasty is indicated in cases with the extra-articular extension. A combination of both treatment methods may be necessary, when the lesion locates extending beyond the medial groove of the condyle.

Arthroscopic management of recurrent synovial chondromatosis of the hip: a case report.

Here the authors report a case of eighteen years lady with recurrent hip synovial chondromatosis who was treated previously with hip arthrotomy and loose bodies removal and now she underwent arthroscopic loose bodies removal with partial synovectomy. In comparison to arthrotomy of the hip, arthroscopic management is a minimally invasive surgery that is associated with decreased postoperative pain, earlier improvement in range of motion, a shorter course of rehabilitation, and overall lower morbidity. Thus, the authors recommend arthroscopic removal of the loose bodies and partial synovectomy for the management of synovial chondromatosis of the hip.