Synovial chondrometaplasia of the hand: case report and review of the literature

Synovial chondromatosis of the hand: Three case reports and literature review

Synovial chondromatosis is a rare condition that is probably caused by synovial connective tissue metaplasia. It is very rare in the hand and wrist and because of its low prevalence and nonspecific symptoms, synovial chondromatosis can present diagnostic difficulties for the hand surgeon and may lead to a delay in treatment. We review the literature and report three additional cases of synovial chondromatosis in the hand.

Uptake of pentavalent technetium-99m dimercaptosuccinic acid in idiopathic synovial chondromatosis

We reported two Tc-99m(V) DMSA scintigrams in patients with idiopathic synovial chondromatosis which affected the metacarpo-phalangeal joint and shoulder joint. Tc-99m(V) DMSA accumulated markedly and diffusely in the tumor. Tc-99m(V) DMSA scintigraphy would be valuable for deciding the optimal site for biopsy.

[Tenosynovial osteochondromatosis of the hand. A case report]

A 14 year old boy presented with swelling of the middle finger. X-rays showed calcifications of the palmar surface of the head of the third metacarpal and over the first and second phalanges. The natural course was followed over a period of two years with a diagnosis of calcifying peritendonitis. Due to the increased volume of the calcification deforming the proximal phalanx, the masses were resected revealing a diagnosis of chondroma. The discovery of free foreign bodies in the synovial sheath of the flexors and histological examination established the diagnosis of tenosynovial osteochondromatosis, which is rarely located in the hand. No recurrence has been observed after 8 years of follow-up.

Fibrous loose body in the flexor tendon sheath

We report the first known example of an entirely fibrous loose body lying in the flexor tendon sheath of a finger. This was seen initially as a painless swelling in a fit young woman and was surgically excised with full restoration of function. The cause of the loose body is unknown, but it may have originated as a fibroma of the flexor tendon sheath or as a localized nodular tenosynovitis.

Synovial chondromatosis in the distal interphalangeal joint

A case of synovial chondromatosis of the distal interphalangeal joint of the long finger with an 8-year follow-up is presented. The lesion recurred 4 years after simple synovectomy, requiring a second operation with arthrodesis.

Extraskeletal osteochondromas of the wrist

Extraskeletal osteochondromas of the wrist are described in two patients. They both had painless, slow-growing wrist masses, one palmar and one dorsal. Radiographs demonstrated the presence of an extraskeletal, radiopaque mass. Excisional biopsy showed extraskeletal, firm, calcified masses. Histologic examination revealed mature hyaline cartilage, with extensive ossification consistent with the diagnosis of extraskeletal osteochondroma. The ambiguous nomenclature for this cartilage lesion and the differential diagnosis of extraskeletal calcification are reviewed.