Primary Synovial Chondromatosis Research Articles

Osteopoikilia in the practice of a rheumatologist

Osteopoikilia (OPC) is a rare, benign autosomal dominant disease characterized by sclerotic bone lesions, which usually proceeds asymptomatically. It is usually diagnosed by accident with conventional radiography. In most patients, the disease is asymptomatic, but some may complain of mild joint pain and swelling. Differential diagnoses of the disease include osteoblastic metastases, primary bone tumor, mastocytosis, tuberous sclerosis, synovial chondromatosis and melanostasis. In the literature, we have found reports of the coexistence of OPC with rheumatological diseases such as fibromyalgia, reactive arthritis, familial Mediterranean fever, psoriatic arthritis, rheumatoid arthritis, seronegative spondyloarthritis. Thus, the clinical case we observed is interesting not only from the standpoint of the importance of establishing a clinical diagnosis, but also the timeliness of starting treatment, which affects the prognosis of the disease.

A Case of Baker’s Cyst with Synovial Chondromatosis of Knee

Synovial chondromatosis is a benign condition which arises from synovial membrane or bursae around the joints. Joint abnormalities in the form of arthritic or mechanical conditions such as detachment of osseocartilaginous fragments from the articular surface are its secondary associations. Rarely there maybe involvement of the Baker’s cyst. Here we report a case in which a 60-year-old female came with complaints of pain, swelling and restriction of movement of right knee joint for the past one year. After careful clinical and radiological examination, it was diagnosed as Baker’s cyst complicated by synovial chondromatosis. After the diagnosis the patient underwent the following procedures: open synovectomy, cyst removal and thorough joint debridement. Synovial chondromatosis was confirmed histopathologically. Secondary synovial chondromatosis has features of osteoarthritic changes, lack of extensive synovial proliferation and complicated Baker's cyst which is not seen in primary synovial chondromatosis.
 Synovial chondromatosis (SC) is caused by metaplasia of the synovium into chondrocytes and is a rare benign disorder.[1,2] Primary synovial chondromatosis (PSC) is a self-limited process that occurs in an otherwise normal joint.[3] When synovial chondromatosis develops in a joint previously affected with disease, often posttraumatic or degenerative osteoarthritis, it is called as secondary synovial chondromatosis.[4] SC may involve any joint, but the most common joint involved is knee joint followed by hip joint, and small joints of the hand and wrist. Least involvement is seen in elbow and shoulder joint. [5] The disease is categorised into three phases according to Milligram classification: active intrasynovial disease without any loose bodies observed in the early phase, active disease and loose bodies observed in the transitional phase, and multiple loose bodies without any intrasynovial disease observed in the late phase.
 In orthopaedic practice, popliteal cysts are common occurrence; many of them are associated with degenerative or rheumatoid arthritis. The differential diagnoses become more complex when loose bodies and calcifications are noted within the joint on a radiograph. Here in, we are presenting a case of Baker’s cyst with synovial chondromatosis of knee treated by surgical excision and confirmed by histopathology.

Crystal induced arthropathies-a comparative study of 40 patients with apatite rheumatism, chondrocalcinosis and primary synovial chondromatosis.

Introduction: Apatite rheumatism (AR), chondrocalcinosis (Ch-C), and primary synovial chondromatosis (prSynCh) are regarded as distinct clinical entities. The introduction of the non-staining technique by Bély and Apáthy (2013) opened a new era in the microscopic diagnosis of crystal induced diseases, allowing the analysis of MSU (monosodium urate monohydrate) HA (calcium hydroxyapatite), CPPD (calcium pyrophosphate dihydrate) crystals, cholesterol, crystalline liquid lipid droplets, and other crystals in unstained sections of conventionally proceeded (aqueous formaldehyde fixed, paraffin-embedded) tissue samples. The aim of this study was to describe the characteristic histology of crystal deposits in AR, Ch-C, and prSynCh with traditional stains and histochemical reactions comparing with unstained tissue sections according to Bély and Apáthy (2013). Patients and methods: Tissue samples of 4 with apatite rheumatism (Milwaukee syndrome), 16 with chondrocalcinosis, and 20 with clinically diagnosed primary synovial chondromatosis were analyzed. Results and conclusion: Apatite rheumatism, chondrocalcinosis, and primary synovial chondromatosis are related metabolic disorders with HA and CPPD depositions. The authors assume that AR and Ch-C are different stages of the same metabolic disorder, which differ from prSynCh in amorphous mineral production, furthermore in the production of chondroid, osteoid and/or bone. prSynCh is a defective variant of HA and CPPD induced metabolic disorders with reduced mineralization capabilities, where the deficient mineralization is replaced by chondroid and/or bone formation. The non-staining technique of Bély and Apáthy proved to be a much more effective method for the demonstration of crystals in metabolic diseases than conventional stains and histochemical reactions.

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

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.

Incidental findings involving the temporomandibular joint on computed tomography and magnetic resonance imaging.

The temporomandibular joint (TMJ) is frequently imaged in head and neck computed tomography (CT) and magnetic resonance imaging (MRI) studies. Depending on the indication for the study, an abnormality of the TMJ may be an incidental finding. These findings encompass both intra- and extra-articular disorders. They may also be related to local, regional or systemic conditions. Familiarity with these findings along with pertinent clinical information helps narrow the list of differential diagnoses. While definitive diagnosis may not be immediately apparent, a systematic approach contributes to improved discussions between clinicians and radiologists and better patient management.

Primary synovial chondromatosis of the hip joint (PrSC of the hip): A retrospective cohort analysis and review of the literature

IntroductionPrimary synovial osteochondromatosis (SOCM) or Synovial chondromatosis (SC) of the hip is a benign metaplastic condition of the synovium that is rare and may present with a spectrum of clinical features and radiological findings. Patients and methodsA retrospective search using the keyword ‘Synovial chondromatosis’ (SC) of the hip was performed at a tertiary care orthopaedic referral centre in the UK and a hospital in India. The radiology images were collected from our Picture Archiving and Communication System (PACS) and Radiology Information System (RIS), over 15 years. The patient's data was collated with Electronic Patient Records (EPR), RIS, and correlated with histo-pathology laboratory records where available. The demographic details of the patients, their clinical symptoms, imaging details, and management outcomes were collected. ResultsWe found 15 cases, with a mean age of 36.53 years (range: 14–50 years). There were 9 male and 6 female patients. The follow-up ranged from 1 year to 6 years. Predominantly unilateral presentation with insidious onset of symptoms was found. A spectrum of radiological Imaging was undertaken. Management strategies included supervised observation, arthroscopic or open synovectomy, and hip arthroplasty. No malignant transformation was found in the analysed cohort. ConclusionPrimary ‘Synovial chondromatosis’ of the hip had a male preponderance in our cohort, presenting with a range of clinical features. Radiologically, Magnetic Resonance Imaging (MRI) was the commonest modality of cross-sectional imaging utilised and crucial for the diagnosis, evaluating underlying articular involvement including guiding appropriate patient management presenting with Primary ‘Synovial chondromatosis’ of the hip.

Primary synovial chondromatosis: an elemental investigation of a rare skeletal pathology.

Primary synovial chondromatosis (PSC) is a rare idiopathic pathology characterised by the formation of osseocartilaginous nodules within synovial joints, tendons, or bursae. The mineralisation pattern of PSC nodules is poorly understood and has yet to be investigated using elemental analysis. Mapping this pattern could elucidate the progression of the disease. Primary synovial chondromatosis nodules discovered during dissection of a formalin fixed donor were analysed. Scanning electron microscopy paired with energy dispersive X-ray spectroscopy (SEM-EDS) was used to quantify calcium and phosphorus levels to distinguish mineralised components from cartilage, indicated by increased carbon and oxygen concentrations. Nine nodules with average dimensions 1.76 cm × 1.25 cm were identified in the semimembranosus bursa. SEM-EDS demonstrated increased calcium phosphate levels in nodular cores, while outer margins contained primarily carbon and oxygen. Quantification of these elements revealed nodular peripheries to contain 68.0% carbon, 30.2% oxygen, 0.8% calcium, and 1.0% phosphate, while cores were comprised of 38.1% carbon, 42.1% oxygen, 14.1% calcium, and 5.7% phosphate. Nodules were found to have mineralised cores embedded within a cartilaginous matrix. This pattern suggests disease progression is facilitated by endochondral ossification, opening the potential for new therapeutic techniques.

Massive Synovial Osteochondriomatosis of The Shoulder: A Case Report and Review of The Literature

Synovial chondromatosis is a generally monoarticular disorder characterized by multiple benign nodular cartilaginous formations, arising as a result of metaplasia of synovial tissue. Other names by which this entity is known are synovial osteochondromatosis, primary synovial chondromatosis, synovial chondrometaplasia. The most frequent location is the knee, hip, shoulder, shoulder, elbow, wrist and temporomandibular joint. It can be primary or secondary to a pre-existing chondromatosis. 1-8 It is an uncommon entity with a worldwide incidence of 1:100,000 with greater involvement of males up to 3 times higher. It usually affects people between 30 and 50 years of age, and although its etiology is unknown, it has been associated with chromosomal effects. In studies published between 1996 and 2002, structural alterations were found, which showed a rearrangement of bands 1p13-p22. 1, 2, 3, 9, 10, 11

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.

Synovial Chondromatosis of Knee


 
 
 
 Synovial chondromatosis (also called synovial osteochondromatosis) is a type of non-cancerous tumor that arises in the lining of a joint. It has been divided into primary and secondary forms. Primary synovial chondromatosis was originally considered to represent chondroid metaplasia in the synovium of a joint with resultant formation of multiple intraarticular chondral bodies. Secondary synovial chondromatosis is associated with joint abnormalities, such as mechanical or arthritic conditions, that cause intraarticular chondral bodies. Primary synovial chondromatosis typically affects adults, predominantly men, in the third to fifth decades of life. Synovial osteochondromatosis manifests clinically with joint pain, swelling, and limitation of motion. Although the condition is not cancerous, it can severely damage the affected joint and, eventually, lead to osteoarthritis. As conclusion, this case is typical of secondary synovial chondromatosis that is the result of a degenerative change in the joint.
 
 
 

A case of primary synovial chondromatosis with peripheral osteoma in the temporomandibular joint

A case of primary synovial chondromatosis with peripheral osteoma in the temporomandibular joint

A case report on synovial chondromatosis in adult with secondary arthritis

Introduction: Primary synovial chondromatosis (PSC) is a rare, usually monoarticular disorder of synovial joints. PSC is characterized by the formation of osteocartilaginous nodules in the synovial connective tissue. Case Description: We report a case of 65 year old male with Primary synovial chondromatosis in left hip. On clinical examination, patient had restricted abduction, rotational movements and a flexion deformity of 30 degree in left hip with an antalgic gait. Patient gives a history of difficulty in walking since last 10 years. The patient had taken some treatment to relieve his pain which were relieved temporarily. Patient's symptoms were only of pain when he started observing a change in gait and progressive deformity since last 2 years. The patient has not taken any definitive treatment for his complaints. Ultrasound examination of the left hip revealed joint effusion and demonstrated numerous multiple hyperechogenic foci. Plain radiographs anteroposterior view of pelvis with both hips show multiple soft tissue shadows with multiple irregular shaped calcification around femoral neck. Conclusion: Rounded lesions seen in the joint should always be investigated histopathologically and on the basis of non-invasive investigations for Synovial Chondromatosis. The imaging appearance of PSC appears sufficiently unique to allow its differentiation from other causes of intra-articular pathology. Keywords: Rounded lesions, Synovial Chondromatosis, Osteoarthritis.

Primary Synovial Chondromatosis of Elbow: A Bowl Full of Tumors

Synovial osteochondromatosis is a disease of the synovium characterized by the formation of multiple cartilaginous bodies. The disease is characteristically monarticular, most commonly involving the knee. Despite frequent mention of elbow involvement in various texts and articles, we wish to review the clinical, radiologic, and histologic features of synovial osteochondromatosis of the elbow by presenting a case in an elderly male. By correct preoperative diagnosis and complete excision, full range of motion can be achieved in an relatively unforgivable elbow joint even with a delayed presentation. Keywords: Loose bodies, Elbow, Synovial

Surgical hip dislocation for treatment of synovial chondromatosis of the hip.

In the present study, we aimed to evaluate the clinical outcomes of surgical hip dislocation in patients with synovial chondromatosis (SC) of the hip. Seven patients with primary SC of the hip treated with open synovectomy and removal of loose bodies by surgical hip dislocation from 2016 to 2019 were retrospectively reviewed. All patients had numerous and widespread loose bodies based on pre-operative images, including routine radiographs, CT, and MRI. The visual analog scale (VAS) score and Harris hip score (HHS) were collected and analyzed before and after surgery. The post-operative radiographs were reviewed to evaluate disease recurrence and osteoarthritis progression. The mean operative time was 61 minutes(range, 42-75min). An average of 33 loose bodies in each patient (range, 16-67) was removed, and extra-articular pathology was found in one patient. Patients were followed up for a mean duration of 30months (range, 18-42months). The average VAS scores were decreased from 3.7 (range, 2-6) pre-operatively to 0.9 (range, 0-2) at the last follow-up, and the HHS was improved from 60.1 (range, 50-73) to 90.1 (range, 82-95). All results demonstrated significant improvements (P < 0.05). Post-operative radiographs showed no recurrence, osteoarthritis progression, or osteonecrosis of the femoral head in all hips. Surgical hip dislocation was a practical approach for managing both intra-articular and extra-articular pathologic lesions around the hip. It was an effective treatment for SC of the hip with short surgical time, good joint functions, a lower recurrence rate, and few complications.

Imaging features of synovial chondromatosis of the temporomandibular joint: a report of 34 cases

To investigate the imaging features of synovial chondromatosis of the temporomandibular joint (TMJ), which is a rare benign arthropathy with cartilaginous proliferation. Computed tomography and magnetic resonance imaging examinations of 34 patients with histopathologically confirmed primary synovial chondromatosis of the TMJ were reviewed retrospectively. Imaging features including the lesion epicentre, destruction/sclerosis of surrounding bone, calcification, periosteal reaction, osteophyte, lesion size, and joint space dimensions were assessed. Thirty-one of thirty-four patients (91.2%) showed the superior joint space as the lesion epicentre. For the mandibular condyle, more than one-third of patients (14/34; 41.2%) showed no destruction, and more than half of patients (19/34; 55.9%) showed no sclerosis. Conversely, >70% of patients showed destruction and sclerosis of the articular eminence/glenoid fossa, while >80% of patients (28/34; 82.4%) presented with various calcifications, including the ring-and-arc (9/34; 26.5%) and popcorn (13/34; 38.2%) types. The mean joint space on the affected side was significantly larger than that of the unaffected side (p<0.001). More than three-fourths of patients (76.9%) experienced no interval increase in lesion size during an average of 1.6 years of follow-up. Synovial chondromatosis of the TMJ demonstrated several imaging features, including the lesion centre being located in the superior joint space, resultant articular eminence/glenoid fossa-oriented bone changes, ring-and-arc and popcorn calcification, joint space widening, and self-limiting growth. These imaging features may be helpful in differentiating synovial chondromatosis from other lesions of the TMJ.

Arthroscopic Management of Synovial Osteochondromatosis of the Elbow

Primary synovial chondromatosis is characterized by newly formed chondral or osteochondral nodules in the synovial membrane, which may detach and form loose bodies. The loose bodies can be calcified or ossified, and the condition is termed synovial osteochondromatosis. Three distinct stages can be identified in primary synovial chondromatosis : phase I is active synovitis without loose bodies, phase II shows nodular synovitis along with loose bodies, and phase III is characterized by the presence of loose bodies with the resolution of synovitis. Surgical treatment has been recommended as the first choice of therapy in phases II and III disease. Complete synovectomy and removal of all loose bodies is advisable for prevention of recurrence of the disease. In this technical note, the technical details of arthroscopic removal of loose bodies and synovectomy for the management of synovial osteochondromatosis of the elbow is described. Compared with open procedures, the arthroscopic approach has many advantages, including a shorter rehabilitation period and higher patient satisfaction.

Primary Synovial Chondromatosis of the Shoulder

A 35-year-old man was referred to physical therapy with nondominant right shoulder pain. Due to chronicity of symptoms and impairment of strength and mobility, the physical therapist ordered radiographs. An orthopaedic consultation was initiated, and the patient was diagnosed with primary synovial chondromatosis. Magnetic resonance imaging was ordered in preparation for surgery. JOSPT Cases 2021;1(1):40–41. doi:10.2519/josptcases.2021.9733