Extra-articular Synovial Chondromatosis Research Articles

Revisiting The Synovial Chondromatosis with A Short Review of The Literature

Synovial chondromatosis is a benign neoplastic process representing hyaline cartilage nodules formed in a joint. In adult males, the knee joint is the most commonly affected in the Indian population. The hyaline cartilage nodules may detach from the synovium and may present as enlarged free nodules in the subsynovial tissue of joint, tendon sheath or bursa. In primary changes of synovial chondromatosis plain radiograph is not able to assess the free hyaline cartilage nodules. For further workup, magnetic resonance imaging is the essential imaging investigation to evaluate the cartilage and for the surgical planning. The extension of synovial disease, especially peripheral soft tissue involvement and lobular growth, are demonstrated more precisely on MRI. The treatment of choice in the case of primary synovial chondromatosis is surgical resection, either intraarticular or extraarticular; however, the recurrence is higher in extraarticular synovial chondromatosis. Along with the synovectomy surgical resection or removal of the hyaline cartilage nodules is also necessary. This case report discusses a 45-old female patient having synovial chondromatosis along with a short literature review.

Condromatosis sinovial extraarticular de pie. Reporte de un caso y revisión de la bibliografía.

La condromatosis sinovial es una lesión poco frecuente caracterizada por la metaplasia cartilaginosa de la membrana sinovial de pequeñas y grandes articulaciones. Se suelen observar múltiples nódulos cartilaginosos y un grado variable de destrucción articular. Las manifestaciones clínicas son variables y dependen de la localización y el estadio de la enfermedad. Nuestra paciente concurrió con una tumoración en la planta del pie a nivel de la raíz del segundo y tercer dedo, de meses de evolución. Luego de los estudios por imágenes correspondientes y evidenciar la extensión dorsal de la lesión, se decidió realizar la resección en bloque a través de doble abordaje; el análisis anatomopatológico informó condromatosis sinovial. La ausencia de extensión intrarticular fue constatada en la cirugía. Este caso representa una manifestación poco frecuente de la patología no solo por su localización, sino también por su ubicación extrarticular. Según nuestra búsqueda bibliográfica, no se han publicado reportes de casos con condromatosis sinovial extrarticular avanzada (grado 3) en el antepié y creemos que debería ser considerada dentro de las lesiones tumorales de aspecto cartilaginoso en esta localización.

Extra and Intra-articular Synovial Chondromatosis

Synovial chondromatosis is not so rare intra-articular condition secondary to synovial metaplasia, that affects the knee joint. Extra-articular synovial chondromatosis however is an extremely rare condition that usually involves the synovial sheath or bursa of the foot or hand. We present two cases of synovial chondromatosis, one intra and one extra-articular. The first case was a 25 year old lady who presented with pain, swelling and restricted range of motion of left knee and was found to have an intra-articular synovial chondromatosis which was treated successfully by joint debridement. The second case was that of a 22 year old man who presented with right knee pain and was diagnosed to have an extra-articular synovial chondromatosis of his right medial hamstring tendon sheath, excision of which resulted in complete relief of symptoms.

Coxa saltans caused by extraarticular synovial chondromatosis overlying an isolated osteochondroma of the greater trochanter: A rare aetiology.

Snapping hip is produced by intraarticular and extraarticular pathology. We describe a rare case of extraarticular snapping hip caused by bursal synovial chondromatosis overlying an osteochondroma. A 32-year-old male presented with swelling in his right gluteal region for 6 years associated with pain and snapping on movements since three months. On examination, he had an ill-defined 10×6cm swelling over the posterolateral aspect of the greater trochanter. Plain radiographs revealed an osteochondroma arising from the greater trochanter. Further imaging showed exostosis with possible haemangioma, lipoma or liquefied haematoma overlying it. We proceeded with excision biopsy and intraoperatively found a bursa with synovial chondromatosis overlying the exostosis. At the end of ten months follow up, patient was asymptomatic and had no snapping. We present this case for its rarity, clinical and radiological diagnostic challenges and for its unique presentation.

Bursal synovial chondromatosis formation following osteochondroma resection

Osteochondroma is a common tumor of the bone and can be complicated by adventitial bursa formation and malignant transformation of the cartilaginous cap. Synovial chondromatosis formation within these bursae is extremely rare and can be confused with malignant transformation of the osteochondroma cap to a chondrosarcoma. We describe a case of extra-articular synovial chondromatosis formation several years following osteochondroma resection. Cartilage nodule formation within the bursal synovial lining and proliferation of cartilage debris shed from the cartilaginous cap during surgery or biopsy are potential etiologies of this rare complication of osteochondromas.

A giant radiopaque mass in the masticatory space

A 2-year-old boy presented with a giant mass in the masticatory space. The mass exhibited a lobulating ossification, with no attachment to the adjacent normal bone. An enucleation was performed under the tentative diagnosis of extra-articular synovial chondromatosis, benign ossifying neoplasm, non-neoplastic heterotopic ossification, or low-grade malignancy. Upon microscopic examination, the excised mass was composed of multiple osteocartilaginous areas. We hereby present detailed clinicopathological findings.

A rare case of a swollen knee due to disseminated synovial chondromatosis: a case report

IntroductionA synovial chondromatosis is a rare benign neoplasm on the synovium. Although described as a benign disease, it can be very destructive and can cause severe osteoarthritis and pain. To the best of our knowledge, we report the first known case of an extensive presentation of this intra-articular and extra-articular disease of the knee joint.Case presentationA 49-year-old Caucasian man presented with right knee pain and stiffness caused by diffuse intra-articular and extra-articular synovial chondromatosis. He underwent careful preoperative imaging and planning followed by a two-stage arthroscopic and open procedure in order to completely eradicate the disease. He has regained full range of movement, but continues to experience residual pain due to severe osteoarthritis.ConclusionsAlthough synovial chondromatosis is described as a benign disease, it can be very destructive and debilitating. A challenging management dilemma arises when confronted with both synovial chondromatosis and osteoarthritis.

Extra-articular synovial chondromatosis in a prepatellar bursa

We report a case of an extremely rare form of a localized extra-articular synovial chondromatosis in a prepatellar bursa. Synovial chondromatosis (SC) is an uncommon and benign disease of the synovium characterized by formation of multiple loose bodies, most of which subsequently become calcified and/or ossified. The process typically affects large joints however an extra-articular variant has, rarely, been reported in bursae and tendon sheaths. To the best of our knowledge, this is the first report in the English language literature of extra-articular synovial chondromatosis in this location.

A Case Of Primary Intra-Articular And Extra Articular Synovial Chondromatosis Of Ankle And Foot

Synovial chondromatosis is a cartilaginous lesion arising from the synovial connective tissue, which may occur intraarticularly or extraarticularly. We report a case of intra plus extra articular synovial chondromatosis of ankle and foot. A 32-year-old male patient presented to us with pain, restricted dorsiflexion and frequent locking of the left ankle joint .X ray and clinical examination confirmed diagnosis of intra plus extra articular synovial chondromatosis. Intra-articular pathology was treated with arthroscopic excision of loose bodies and synovectomy, while extraarticular lesion was treated with open excision. Histopathological examination confirmed the diagnosis. Such combination of synovial chondromatosis is very rare and clinically very significant due to its tendency for local recurrence and potential malignant transformation. We reported this case considering its rarity and clinical significance in view of diagnosis and management.

Extra-articular giant solitary synovial chondromatosis of the foot: a case report and literature review

The term giant solitary synovial chondromatosis (GSSC) is used when lesions measure over 1 cm, but the size may vary from 1 to 20 cm. It is a rare entity and, to our knowledge, this case of giant extraarticular synovial chondromatosis measuring 9 × 6 cm involving the sole of the foot is only the second case described in the literature. A 75-year-old man had a swelling over the dorsolateral border of the left foot for 8 years which was treated initially as a ganglion. The differential diagnosis was ganglion or lipoma. The swelling later involved the sole and planto-medial aspect of the foot. A radiograph of the left foot was normal, but a magnetic resonance imaging (MRI) scan revealed a big soft tissue mass extending from the lateral to the medial side of the left foot on the plantar aspect with indentation of plantar fat. Biopsy showed synovial chondromatosis with extensive necrosis.

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A patient with combined intraarticular and extraarticular synovial chondromatosis is reported. A 14 year-old girl visited our hospital with the complaint of swelling and pain at the anteromedial side of the left talus. Spotty calcification and invasion to the talar neck was seen on the plain radiogram. 99mTc and Ga-citrate scintigraphy were positive at the same location. Digital subtraction angiography revealed hypervascularity and tumor stain. Considering the possibility of malignant lesion, we performed operation for biopsy and exploration. Chondromatous free bodies were resected, three from the ankle joint and one from extraarticular synovium. Histological findings were typical synovial chondromatosis.

Extra-articular synovial chondromatosis

Four patients with extra-articular synovial chondromatosis and one patient with combined intra-articular and extra-articular involvement are described. In all five patients the lesion was anomalously located (knee, shoulder, hip, and ankle). The lesion usually occurs in the hands and feet. Accurate diagnosis is important, because if the synovial origin of the cartilaginous proliferations is ignored, the evidence of cellular activity may lead to an erroneous diagnosis of chondrosarcoma. All five patients had a benign clinical course.