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Synovial Chondromatosis

Discussion

  • a monarticular synovial proliferative disease which is characterized by the metaplastic conversion of cartilagenous tissue to ossified loose bodies;
  • cartilagenous or osteocartilaginous metaplasia takes place w/in the synovial membrane of joints, bursae, or tendon sheaths;
  • seen most often in middle-aged men;
  • pts report pain and limitation of motion;

location

  • over one-half of cases occur in the knee, followed by the elbow;
  • other common sites include the hip, shoulder, wrist and ankle;
  • when located in the foot or ankle the term "soft tissue chondroma" may be used;

classification

  • early: no loose bodies but active synovial disease;
  • transitional: active synovial disease, and loose bodies;
  • late: loose bodies but no synovial disease;

diff dx

Radiographs

  • intraarticular loose bodies are seen in > 70%;
  • when radiographs are negative, MRI may show cartilagenous bodies;
  • MRI will show high signal on T2 weighted images;

Treatment

  • total open synovectomy is the treatment of choice;
  • recurrence rate is over 25%

References