Synovial Osteochondromatosis Research Articles

Efficacy of Outside-In Hip Arthroscopy without Traction in the Treatment of Hip Synovial Osteochondromatosis.

Arthroscopic treatments of hip synovial osteochondromatosis are mostly performed under traction, resulting in neurovascular injury or iatrogenic damage to the labrum or cartilage. This study aimed to assess the effectiveness of outside-in hip arthroscopy without traction in treating hip synovial osteochondromatosis. This retrospective study was conducted on a series of patients with hip synovial osteochondromatosis treated using outside-in hip arthroscopy without traction in our hospital between 2018 and 2020. Plain radiography and magnetic resonance imaging (MRI) scans were obtained. The Harris hip score (HHS), hip range of motion (ROM), and visual analog scale (VAS) scores were analyzed. The preoperative scores and last follow-up scores were compared with a paired-sample t test. The complications and recurrence postsurgery were recorded. This study included five patients (three male and two female) with an average age of 41 years (range 28-54 years). The mean follow-up time was 25.2 months (range 18-36 months). All patients experienced groin pain relief and improved ROM. The mean VAS score was significantly lower postoperatively (0.4 ± 0.5) than preoperatively (3.2 ± 0.8) (p < 0.001). The mean HHS improved from 58.6 ± 12.7 (range 43-73) to 89.8 ± 5.26 (range 81-95) (p < 0.001). No major complications, including infection, perineal numbness and swelling, neurotrosis, thromboembolism, or severe persistent pain, were reported. Synovial osteochondromatosis recurred in one patient after 2 years of follow-up without any obvious symptoms such as hip pain or joint locking. Therefore, no further treatment was necessary. This study showed that outside-in hip arthroscopy without traction might be a viable option for treating hip synovial osteochondromatosis, effectively and safely relieving symptoms with minimal complications, especially in patients without lesions in the central compartment.

EVALUATION OF CLINICAL RESULTS OF SURGICAL RESECTION OF SYNOVIAL OSTEOCHONDROMATOSIS IN THE SHOULDER: A RETROSPECTIVE STUDY

Synovial osteochondromatosis of the shoulder is a rare condition and its details remains unclear. Aim of this study was to evaluate the clinical results of surgical resection and histopathological characteristic of SOC of the shoulder. Ten shoulders with SOC were retrospectively assessed for demographic characteristic, history of trauma, presence of osteochondral loose bodies, inferior humeral osteophytes and acromial spurs. Visual analog scores for pain and functional scores using Constant scores were compared pre and post operatively. Resected lesions were histo-pathologically differentiated between primary and secondary SOC. The average age of patients was 39.8+/- 15.7 year; four female and six patients was male in our study. Average duration of symptoms was 11.5+/-8.11 months. Three shoulders has osteochondral lesion in subacromial space (30%) and seven in glenohumeral joint (70%). Five shoulders (71%) show inferior humeral osteophytes out of seven shoulders with lesion in glenohumeral joint. All three shoulder (100%) with SOC in the subacromial space had spur formation. One shoulder have primary SOC while other nine had secondary SOC. Average Visual analog scale pain score graded from 0 (no pain) to 100 mm( maximal pain) was 47.5+/-11.32 mm. The Constant score was improved from preoperative score 51.6+/-8.34 points to postoperative score 78.7+/-11.62. No case show recurrence of new loose bodies, acromial spur and inferior humeral osteophytes. Our study showed that resection of SOC successfully relieved the pain and clinical symptoms. Primary SOC is less common than secondary SOC and histopathological identification is needed to differentiate between both types. Thus further investigations required to determine long term prognosis SOC in the shoulder. KEYWORDS: osteochondromatosis, shoulder joint, synovium

Neurologic recovery following laminectomy and tumor resection of a pediatric cervical synovial osteochondromatosis causing paralysis.

To report the surgical outcome of synovial osteochondromatosis, a rare tumor of the cervical spine, in a 6-year-old boy. A 6-year-old boy presented with muscle weakness in the right deltoid (2) and biceps (4) during a manual muscle test. Magnetic resonance imaging showed a 3 × 2 × 1.5cm mass within the spinal canal at the C4-6 level, compressing the cervical spinal cord from the right side. Computed tomography revealed hyperintense areas within the tumor and ballooning of the right C4-5 and C5-6 facet joints. After a biopsy confirmed the absence of malignancy, a gross total resection was performed. The pathological diagnosis of synovial osteochondromatosis was established. Postoperatively, muscle weakness improved fully in the manual muscle test, and there were no neurological findings after 3months. However, the patient is under careful follow-up owing to the detection of a regrowth site within the right C4-5 and C5-6 intervertebral foramen 2years postoperatively. Synovial osteochondromatosis of the cervical spine in children is rare, and this is the first report of its regrowth after surgery. Synovial osteochondromatosis should be included in the differential diagnosis of pediatric cervical spine tumors.

Radiological findings of Secondary Synovial Chondromatosis of Elbow Joint: A Case Report

Synovial Chondromatosis (SC), previously known as synovial osteochondromatosis, is usually an uncommonly encountered condition. Pathologically, the condition involves the formation of multiple cartilaginous nodules that arise from the synovium of facet joints and may detach from the synovium to form loose bodies in or around the joint space. While X-rays help in the early detection of loose bodies in SC, advanced diagnostic modalities such as Computed Tomography (CT) scans and Magnetic Resonance Imaging (MRI) aid in preoperative diagnosis and work-up. Authors hereby, report a unique case of secondary SC of the elbow joint in a 50-year-old male patient who presented with complaints of swelling, chronic elbow pain, and joint stiffness with restricted movement following an old traumatic injury. The patient was clinically misdiagnosed as having ‘Myositis Ossificans’ due to the history of massaging the elbow joint following trauma by a local practitioner. However, radiological investigations revealed multiple intra- and extra-articular loose bodies of varying sizes and stages of calcification, leading to a diagnosis of ‘Secondary SC’. SC is a rare entity that is often misdiagnosed during clinical examinations. Therefore, extensive radiological evaluation is necessary for the accurate and early diagnosis of the condition. Early surgical management can restore the Range of Motion (ROM) of the affected joint and prevent secondary osteoarthritic changes.

Anteriorly pedicled deep layer of temporalis muscle flap for disc replacement after temporomandibular discectomy

ObjectiveAn anteriorly pedicled temporalis muscle flap has a functional advantage for temporomandibular (TMJ) joint reconstruction. However, the greater thickness of the flap for disc replacement after discectomy might cause several postoperative complications including malocclusion. The temporalis muscle can be split into the thin superficial and thick deep layers; they are separated by a thin fatty layer. Therefore, we developed the modified anteriorly pedicled temporalis muscle flap using the deep layer of the temporalis muscle, which has a suitable size for the TMJ space after discectomy without losing the functional advantage. MethodsThe procedure was applied to three patients who underwent discectomy for the treatment of synovial osteochondromatosis. They were followed up from preoperatively to more than 1 year postoperatively. ResultsNo significant postoperative complication were observed in all patients. Additionally, all patients obtained normal jaw function without malocclusion from immediately after the surgery. ConclusionThis technique offers some advantages in disc replacement after discectomy.

Arthroscopic Synovectomy and Removal of Loose Bodies in Synovial Osteochondromatosis of the Knee

Synovial osteochondromatosis is a benign process that most commonly affects the knee joint (70%). It is characterized by proliferative metaplasia of synovial membrane into chondrocytes, resulting in the formation of multiple cartilaginous nodules, which can detach from the synovium to become multiple intra-articular loose bodies. It usually involves the anterior compartment, including infrapatellar fat pad, suprapatellar pouch, and anterior interval, and rarely involves the posterior compartment of the knee. Treatment for synovial osteochondromatosis usually involves surgery, especially in the presence of locking symptoms or decreased range of motion. Arthroscopy has gradually replaced a traditional open approach, resulting in low morbidity, low postoperative pain, better cosmetic results, early recovery of range of motion, short rehabilitation course, and an early return to previous function. In case of involvement of the posterior compartment of the knee joint, arthroscopic access may be difficult. In this Technical Note, the technical details of arthroscopic synovectomy and removal of loose bodies in synovial osteochondromatosis of the knee is described. This arthroscopic technique can deal with the disease, involving both the anterior and posterior compartments of the knee joint.

“Feeling -The -Rice- Bag” Sign: A Pathognomonic Manifestation of Synovial Osteochondromatosis

Synovial Osteochondromatosis is not rare in joint pathology.An orthopaedic surgeon may have around 30 cases in life career. The inner surface of synovium is presumably affected by inflammatory process and forms the osteochondral body. By the time this osteochondral formation detaches from synovium and becomes loose body in the joint. Synovial Osteochondromatosis is a pathological status in which there are multiple loose bodies inside the joint. Synovial Osteochondromatosis is presumably a benign disorder, but whose common complication is blockade of joint when loose body incacerated between cartilages of joint causing acute pain and joint cannot move.In medical terminology there is Osteochondromatosis who is a different pathology, a kind of benign bone tumors, not the title of this article. Multiple loose bodies can be detected by Feeling- the- Rice- Bag Sign. Place the hand over the involved joint, we can feel the loose bodies as if we feel the rice grain in the bag. More loose bodies exist, easier we feel. More superficial the joint and/or loose bodies are , easier feeling is recognized.Feeling -the -Rice- Bag Sign is pathognomonic manifestation for the Synovial Osteochondromatosis.

Medium-term results of the Ascension Pyrotitan surface replacement and Pyrocarbon hemiarthroplasty in the shoulder

HypothesisThe purpose of this study was to review two surgeons’ medium-term results with the Ascension Pyrotitan surface replacement and the Pyrocarbon hemiarthroplasty. We hypothesized they would provide good medium-term outcomes with no significant difference between the two implants. MethodsThe first 21 implants were surface replacements and the subsequent 58 hemiarthroplasties making a total of 79. Overall, the minimum follow-up was two years and maximum nine years and nine months (average = five years and six months). The average follow-up for the Ascension Pyrotitan was eight years and two months and Pyrocarbon hemiarthroplasty was five years and two months. Survivorship, Oxford, and Subjective Shoulder Value (SSV) scores, and incidence of squeaking were recorded. The average age at implantation was 57.7 years (range 20-80). Thirty-five were female and 44 male. The indication for surgery was osteoarthritis in 56 patients, post instability in 10 patients, post fracture in 7 patients, avascular necrosis in 4 patients, synovial osteochondromatosis in one, and rheumatoid arthritis in one. ResultsOf the 79 patients in the cohort, five were deceased, two were revised to reverse for cuff failure, one was revised for Cutibacterium acnes infection, and one was revised to Pyrocarbon hemiarthroplasty for fracture of a Pyrotitan surface replacement. This left 70 patients, all of whom were included in this review. Survivorship at final follow-up for the Pyrotitan surface replacement was 88.9% and Pyrocarbon hemiarthroplasty was 96.4%. The average SSV for all patients reviewed was 86%, the Ascension Pyrotitan patients scoring 87% and the Pyrocarbon hemiarthroplasty scoring 86%. The average Oxford score for the whole cohort was 42 out of a maximum of 48, with Ascension Pyrotitan scoring 42.3 and Pyrocarbon hemiarthroplasty 41.9. Recent Oxford score for the postinstability group was 44, osteoarthritis 42.6, postfracture 39.5, and 35 for avascular necrosis (not statistically significant). Fourteen of 70 patients reported squeaking (20%), 4 daily, 5 weekly, and 5 monthly. Average Oxford score in those who experienced squeaking was 39 compared with nonsqueakers at 43 (P = .02). Correlation between Oxford score and SSV was high with a correlation coefficient of 0.79. The Oxford score for the Pyrotitan at 42.3 was significantly better than the New Zealand Joint Registry score for the Global Cap at 34.5 (P = .001) and the Pyrocarbon hemiarthroplasty at 41.9 significantly better than the Aequalis CoCr hemiarthroplasty at 36.8 (P = .005) ConclusionPyrocarbon looks to be a durable bearing surface and a good option for the younger osteoarthritic patient where risk of glenoid component failure is high.

Multiple synovial osteochondromatosis of the knee in a child: A case report

We report a case of a child who presented with a clinical history of 11 months of progressive pain and swelling in his right knee. Osteochondromatosis is a rare diseas, whose incidence is 1/100,000. It is a synovial proliferative disease associated with cartilage metaplasia resulting in sporadic multiple intra-articular and extra-articular loose bodies. Our focus is to report a rare case of synovial osteochondromatosis in a child successfully treated with arthroscopic surgery. Due to the rarity of the case, we aimed to remind the practicing surgeons of this diagnosis and share our management.

Extensive Case of Primary Synovial Osteochondromatosis of the Shoulder

Background: &#x0D; Synovial osteochondromatosis is a rare and benign set of cartilaginous tumors that calcify in the synovial layer of joints. These masses reduce a joint's range of motion and produce chronic low-grade pain. They can destroy local tissues such as muscles, ligaments, and nerves. Diagnosis is often delayed due to the rare nature of the condition and the nonspecific symptoms of pain, reduced range of motion, and swelling. &#x0D; The Case: &#x0D; A 49-year-old male presents with right shoulder pain and stiffness that has progressively decreased his range of motion since his teenage years. Radiographic imaging revealed severe glenohumeral arthritis with large calcified bodies surrounding the glenohumeral joint. Shared decision-making led to an anatomic total shoulder arthroplasty (TSA) with biceps tenodesis. Nineteen independent calcified bodies were removed from the right shoulder. Eight weeks after surgery, the patient was happy with his progression. The patient demonstrated significant improvement in the range of motion of the operative extremity.&#x0D; Conclusion: &#x0D; We present this case report to help providers form a complete differential and encourage ordering diagnostic tests that pinpoint the exact condition so referral to appropriate treatment modalities, including surgery, is not delayed.

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.

Synovial chondromatosis of knee joint: a case report

&lt;p class="abstract"&gt;Synovial chondromatosis is a benign condition encountered infrequently within joints which is also known as synovial osteochondromatosis. They present as multiple nodules in the synovium which are either fibrin type or cartilaginous type. The fibrin type usually results from bleeding within the joint, rheumatoid arthritis and tuberculosis. The cartilaginous type is usually due to trauma or osteoarthritis. This typically involves large joints, knee being the most common, rarely small joints also may be involved. Here we report a case of 30-year-old female who presented to us with symptoms of swelling, restriction of movement and pain in the right knee. After clinical and radiological assessment, arthroscopic exploration with loose body removal and synovectomy done, following which patient achieved painless complete range of movements. Histopathological examination confirmed the diagnosis as synovial chondromatosis.&lt;/p&gt;

Primary synovial osteochondromatosis of hip joint in a teenager

Primary synovial osteochondromatosis (PSOC), also known as idiopathic synovial chondromatosis, is a rare benign articular disease with synovial proliferation and metaplasia without any predisposing factor. Clinical and imaging features play a major role in the diagnosis of this condition. We report a case of a young girl presenting with chronic hip pain, and suspected to have PSOC on imaging and confirmed on histopathology. Removal of loose bodies without any creation of surgical femoral dislocation was done as part of her treatment. There was no requirement of synovectomy due to complete synovial destruction secondary to the chronic disease process and such a case has not been reported till date. Patient has completely recovered from her symptoms after surgery.

KNEE SYNOVIAL OSTEOCHORNDROMATOSIS: CASE REPORT, SAUDI ARABIA

A rare benign condition known as synovial osteochondromatosis is characterized by the development of several cartilaginous nodules in the synovial joint. It is a monoarticular or polyarticular joint disease, that is easily diagnosed with radiographs. We decided to present this case as its infrequently seen in our arthroplasty clinic and accidentally found during routine images when the patient presented with pain and limited range of motion.

KNEE SYNOVIAL OSTEOCHORNDROMATOSIS: CASE REPORT, SAUDI ARABIA

A rare benign condition known as synovial osteochondromatosis is characterized by the development of several cartilaginous nodules in the synovial joint. It is a monoarticular or polyarticular joint disease, that is easily diagnosed with radiographs. We decided to present this case as its infrequently seen in our arthroplasty clinic and accidentally found during routine images when the patient presented with pain and limited range of motion.

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

Concomitant lipoma arborescens and synovial osteochondromatosis of the knee.

Intra-articular masses are not a rare finding in routine imaging. This is particularly true in patients with underlying joint diseases such as degenerative arthritis. Nevertheless, concomitant presentation is rather uncommon in imaging studies. The authors report an unusual concomitant lipoma arborescens and synovial osteochondromatosis (which has not previously been reported in the literature to the best of the authors' knowledge) in a man in his 60s with a long-standing history of knee osteoarthritis. In this case presentation, we review the differential diagnosis for noninfectious synovial proliferative disorders presenting as intra-articular masses, their potential association with underlying joint pathology, and discuss the key imaging features and appropriate treatment.

Synovial Osteochondromatosis: Clinical Characteristics Unique to the Shoulder.

Synovial osteochondromatosis (SOC) of the shoulder is a rare condition with unclear characteristics. This study evaluated the clinical features and postoperative functional outcomes of SOC of the shoulder that are distinct from SOC of other joints. The characteristics of 28 shoulders with SOC that underwent arthroscopy were retrospectively assessed. Ten shoulders (35.7%) had rotator cuff tears (RCTs) and underwent concomitant arthroscopic rotator cuff repair. The mean follow-up period was 83.6 months (range, 24-154 months). Demographic characteristics and loose bodies localized under arthroscopy were compared between cases with and without concomitant RCTs. Radiography, ultrasonography, or magnetic resonance imaging were performed preoperatively and postoperatively. Visual analog scale (VAS) scores for pain and satisfaction were evaluated for all cases, and functional scores were assessed in shoulders with concomitant RCTs. The average age was 36.2 ± 15.6 years among patients without RCTs and 58.3 ± 7.2 years among patients with RCTs. Seven shoulders (7%) had osteoarthritis. Arthroscopy revealed loose bodies in multiple spaces, including the glenohumeral joint, subacromial (SA) space, and biceps tendon sheath. Overall, loose bodies were found in multiple spaces in 12 shoulders (42.9%). Loose bodies were found in the SA space only in 4 shoulders (22.2%) without RCTs and in 7 shoulders (70.0%) with RCTs. VAS for pain decreased significantly from 3.9 ± 2.3 to 1.1 ± 1.3 (p < 0.001). The functional scores increased significantly after arthroscopic management for patients with concurrent RCTs (all p < 0.05). Recurrence of SOC occurred in 3 of the 22 shoulders (13.6%) who underwent postoperative imaging, but no patient had a recurrent RCT. Pain relief and patient satisfaction were achieved via arthroscopic management. Unlike in other joints, loose bodies can occur simultaneously in several spaces in the shoulder, including the glenohumeral joint, SA space, and biceps tendon sheath. Early diagnosis of SOC of the SA space can help prevent osteoarthritis and RCT progression.

Two cases report of synovial osteochondromatosis of the hand

Two cases report of synovial osteochondromatosis of the hand

Treatment Outcome of Synovial Osteochondromatosis of the Hip Joint

Treatment Outcome of Synovial Osteochondromatosis of the Hip Joint