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Botros D, Ford K, Holderread B, Mollabashy A, Rizkalla J. Synovial chondromatosis of the distal radio-ulnar joint. Proc (Bayl Univ Med Cent) 2021; 34:701-702. [PMID: 34732993 DOI: 10.1080/08998280.2021.1953877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
Synovial chondromatosis (SC) is a benign metaplastic proliferation of cartilaginous nodules within the synovial membrane. Primary SC, though a rare monoarticular disease, significantly impacts patients' functional and pain-related outcomes. We outline the case of a 52-year-old man who presented with a large mass on the volar-ulnar aspect of his left wrist. Biopsy and workup revealed SC of the distal radio-ulnar joint. Though most cases of SC can be managed with arthroscopic or intralesional resection of the mass, a subset of extremely aggressive cases of SC may ultimately fail intralesional resection. Patients must be counseled about the possibility of amputation as an ultimate treatment option for the resolution of their pain and symptoms.
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Affiliation(s)
- David Botros
- Department of Neurological Surgery, The Johns Hopkins University School of Medicine , Baltimore , Maryland.,Department of Orthopedic Surgery, Coptic Medical Association of North America Research Institute , Dallas , Texas
| | - Ken Ford
- Department of Orthopedic Surgery, Baylor University Medical Center , Dallas , Texas
| | - Brendan Holderread
- Department of Orthopedic Surgery, Baylor University Medical Center , Dallas , Texas
| | - Al Mollabashy
- Department of Orthopedic Surgery, Baylor University Medical Center , Dallas , Texas
| | - James Rizkalla
- Department of Orthopedic Surgery, Coptic Medical Association of North America Research Institute , Dallas , Texas.,Department of Orthopedic Surgery, Baylor University Medical Center , Dallas , Texas
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2
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Zacharia B, Inassi J, Paulose S. Retrospective analysis of the clinical and radiological profile of few cases of synovial osteochondromatosis with a literature review. Eur J Rheumatol 2020; 8:40-45. [PMID: 33226330 DOI: 10.5152/eurjrheum.2020.20132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 08/28/2020] [Indexed: 11/22/2022] Open
Abstract
Synovial osteochondromatosis (SOC) is a rare benign neoplasm. It is caused by the metaplasia of the synovium into the bone. The knee, hip, elbow, shoulder, and ankle are the common sites. Our objective was to retrospectively assess the clinical and radiological features of a few cases of SOC resembling some rheumatological conditions and describe it along with a literature review. A retrospective analysis of the clinical and radiological features of a few cases of SOC mimicking some rheumatological conditions was performed. There were 4 cases: 3 adult men and a young boy. Three cases presented in the elbow and 1 case in the hip. There was a case mimicking osteoarthritis of the elbow in a young individual, another case presented like myositis ossificans of the elbow, and another case was similar to neuropathic arthritis of the elbow. The case in the hip presented as painful limping in the child. SOC can sometimes mimic various conditions affecting the synovial joints. A careful evaluation of the clinical and radiological features can be helpful in the correct diagnosis.
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Affiliation(s)
- Balaji Zacharia
- Department of Orthopedics, Government Medical College, Kozhikkode, Kerala, India
| | - Jojo Inassi
- Department of Orthopedics, Government Medical College, Kozhikkode, Kerala, India
| | - Sanoj Paulose
- Department of Orthopedics, Jubilee Mission Medical College, Trichur, Kerala, India
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3
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Xu C, Yang X. Staged arthroscopic procedure for treating simultaneous shoulder and elbow synovial chondromatosis: A case report and literature review. SAGE Open Med Case Rep 2020; 8:2050313X20951340. [PMID: 32922795 PMCID: PMC7446550 DOI: 10.1177/2050313x20951340] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 07/27/2020] [Indexed: 11/21/2022] Open
Abstract
It is extremely rare for ipsilateral shoulder and elbow synovial chondromatosis to occur simultaneously. We report a very rare case of simultaneous shoulder and elbow synovial chondromatosis in a 53-year-old woman who was treated through staged surgeries. Shoulder arthroscopic synovectomy, debridement, biceps tenodesis, and subacromial decompression were conducted first, followed by elbow arthroscopy 2 months later. Post surgery, there was no recurrence either clinically or radiologically at 2 years follow-up. Despite some loss of the range of motion of the shoulder and muscle strength, the elbow functions recovered fully, and the patient was extremely satisfied with the clinical outcome. We recommend a staged arthroscopic procedure consisting of a thorough synovectomy and joint debridement for this condition.
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Affiliation(s)
- Caiqi Xu
- Department of Sports Medicine, Shanghai Sixth People’s Hospital, Shanghai, China
| | - Xingguang Yang
- Department of Sports Medicine, Shanghai Sixth People’s Hospital, Shanghai, China
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4
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Gambarotti M, Pacheco M, Ruengwanichayakun P, Silvino Vega Jiménez B, Benini S, Bianchi G, Sbaraglia M, Vanel D, Carretta E, Bertoni F, Franchi A, Dei Tos AP, Righi A. Synovial chondrosarcoma: a single-institution experience with molecular investigations and review of the literature. Histopathology 2020; 77:391-401. [PMID: 32506447 DOI: 10.1111/his.14170] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 05/29/2020] [Accepted: 06/02/2020] [Indexed: 12/11/2022]
Abstract
AIMS To evaluate the available diagnostic histological criteria for synovial chondrosarcoma and to screen for the presence of IDH1/IDH2 mutations in a series of cases of this malignant cartilaginous neoplasm. METHODS AND RESULTS Ten cases of synovial chondrosarcoma diagnosed at our institute were reviewed. At presentation, all tumours occurred in adults (median age, 62 years). The most common location was the knee joint (five cases), and the size at diagnosis ranged from 30 mm to 170 mm. Eight patients had secondary synovial chondrosarcomas associated with pre-existing/recurrent or concomitant synovial chondromatosis. Five patients had local recurrences and three had lung metastases. All patients with intralesional excisions developed local recurrences, whereas those who underwent wide resections did not. At last follow-up (mean, 91 months), available for nine patients, seven patients were alive and disease-free, one patient had died of disease, and one was alive with paravertebral metastases. Frequent histological features observed included loss of clustering of chondrocytes (nine cases), the presence of variable amounts of myxoid matrix (eight cases), peripheral hypercellularity (eight cases), tumour necrosis (six cases), and spindling of chondrocytes (four cases). Of the seven cases for which it was possible to evaluate bone permeation, six showed infiltration of bone marrow. All seven cases screened for mutations of exon 4 of IDH1 and IDH2 were found to be wild-type. CONCLUSIONS Histological criteria in correlation with clinical and radiological features allow the recognition of synovial chondrosarcoma. IDH1/IDH2 mutations were not present in synovial chondrosarcoma. Adequate surgical margins are important for disease control.
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Affiliation(s)
- Marco Gambarotti
- Department of Pathology, IRCCS, Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Marina Pacheco
- Department of Pathology, IRCCS, Istituto Ortopedico Rizzoli, Bologna, Italy
| | | | | | - Stefania Benini
- Department of Pathology, IRCCS, Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Giuseppe Bianchi
- Department of Orthopaedic Oncology, IRCCS, Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Marta Sbaraglia
- Department of Pathology, Azienda Ospedale Università, Padova, Italy
| | - Daniel Vanel
- Department of Pathology, IRCCS, Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Elisa Carretta
- Statistical Service, IRCCS, Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Franco Bertoni
- Department of Pathology, Villa Erbosa Hospital, Bologna, Italy
| | - Alessandro Franchi
- Department of Translational Research, University of Padua School of Medicine, Pisa, Italy
| | - Angelo P Dei Tos
- Department of Pathology, IRCCS, Istituto Ortopedico Rizzoli, Bologna, Italy.,Department of Pathology, Azienda Ospedale Università, Padova, Italy.,Department of Medicine, School of Medicine, University of Pisa, Padua, Italy
| | - Alberto Righi
- Department of Pathology, IRCCS, Istituto Ortopedico Rizzoli, Bologna, Italy
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5
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Utashima D, Matsumura N, Suzuki T, Iwamoto T, Ogawa K. Clinical Results of Surgical Resection and Histopathological Evaluation of Synovial Chondromatosis in the Shoulder: A Retrospective Study and Literature Review. Clin Orthop Surg 2020; 12:68-75. [PMID: 32117541 PMCID: PMC7031439 DOI: 10.4055/cios.2020.12.1.68] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Accepted: 05/30/2019] [Indexed: 11/06/2022] Open
Abstract
Background Synovial chondromatosis occurs rarely in the shoulder, and its details remain unclear. The purpose of this study was to clarify the clinical results of surgical resection and the histopathological findings of synovial chondromatosis in the shoulder. Methods Ten shoulders with synovial chondromatosis that had been operatively resected were reviewed retrospectively. Osteochondral lesions were present in the glenohumeral joint in six shoulders and in the subacromial space in four shoulders. Two patients had a history of trauma with glenohumeral dislocation without recurrent instability, and the other seven patients (eight shoulders) did not have any traumatic episodes or past illness involving the ipsilateral shoulder girdle. The occurrences of osteochondral lesions, inferior humeral osteophytes, and acromial spurs were assessed on radiographs before resection, just after resection, and at final follow-up. The Constant scores were compared before resection and at final follow-up with Wilcoxon signed-rank tests. Resected lesions were histopathologically differentiated between primary and secondary synovial chondromatosis. Results Inferior humeral osteophytes were found in five shoulders with synovial chondromatosis in the glenohumeral joint, and all four shoulders with synovial chondromatosis in the subacromial space had acromial spur formation. Osteochondral lesions appeared to have been successfully removed in all shoulders on postoperative radiographs. At the final follow-up, however, one shoulder with secondary synovial chondromatosis in the subacromial space showed recurrence of osteochondral lesions and acromial spur formation. The mean Constant score improved significantly from 53.0 points before resection to 76.0 points at a mean follow-up of 6.0 years (p = 0.002). On histopathological evaluation, one shoulder was diagnosed as having primary synovial chondromatosis, while nine shoulders had secondary synovial chondromatosis. Conclusions The present study showed that resection of shoulder osteochondral lesions successfully relieved the clinical symptoms and that primary synovial chondromatosis is less common than secondary synovial chondromatosis in the shoulder. Although most of the present osteochondral lesions were clinically determined to be primary chondromatosis, only one case was histopathologically categorized as primary synovial chondromatosis. These results suggest that histopathological identification is needed to differentiate between primary and secondary synovial chondromatosis.
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Affiliation(s)
- Daisuke Utashima
- Department of Orthopedic Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Noboru Matsumura
- Department of Orthopedic Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Taku Suzuki
- Department of Orthopedic Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Takuji Iwamoto
- Department of Orthopedic Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Kiyohisa Ogawa
- Department of Orthopedic Surgery, Eiju General Hospital, Tokyo, Japan
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6
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Monestier L, Riva G, Stissi P, Latiff M, Surace MF. Synovial chondromatosis of the foot: Two case reports and literature review. World J Orthop 2019; 10:404-415. [PMID: 31840021 PMCID: PMC6908443 DOI: 10.5312/wjo.v10.i11.404] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Revised: 05/17/2019] [Accepted: 09/16/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Primary synovial chondromatosis (PSC) is a rare arthropathy of the synovial joints characterized by the formation of cartilaginous nodules, which may detach and become loose bodies within the joint and may undergo secondary proliferation. PSC of the foot and ankle is exceedingly rare, with only a few cases reported in the literature. The diagnosis may be difficult and delayed until operative treatment, when it is confirmed by histological assessment. PSC may degenerate into chondrosarcoma. Operative treatment is the gold standard aiming to minimize pain, improve function, prevent or limit progression of arthritis. Surgical treatment consists in debridement by arthrotomic or arthroscopic management, but there is no consensus in the literature about timing of surgery and surgical technique. Thus, the aim of this study is to report the outcomes of the surgical treatment of two cases, together with a literature review.
CASE SUMMARY We report two cases of patients affected by PSC of the foot in stage III, according to the Milgram classification: the former PSC localized in the ankle that underwent open surgery consisted of loose bodies removal; the latter in the subtalar joint, and the choice of treatment was the arthrotomy and debridement from loose bodies, in addition to the subtalar arthrodesis. Both patients returned to complete daily and working life after surgery.
CONCLUSION Synovial chondromatosis is a rare benign pathology, even rarer in the ankle joint and especially in the foot. Surgery should be minimal in patients with ankle PSC, choosing the correct timing, waiting if possible until stage III. More aggressive and early surgery should be performed in patients with PSC of the foot, particularly the subtalar joint, due to the high risk of arthritic evolution.
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Affiliation(s)
- Luca Monestier
- Orthopedic and Trauma Unit, ASST Settle Laghi, Varese 21100, Italy
| | - Giacomo Riva
- Orthopedic and Trauma Unit, ASST Settle Laghi, Varese 21100, Italy
| | - Placido Stissi
- Residency Program in Orthopedics and Trauma, University of Insubria, Varese 21100, Italy
| | - Mahfuz Latiff
- Residency Program in Orthopedics and Trauma, University of Insubria, Varese 21100, Italy
| | - Michele Francesco Surace
- Orthopedic and Trauma Unit, ASST Settle Laghi, Varese 21100, Italy
- Interdisciplinary Research Centre for Pathology and Surgery of the Musculoskeletal System, Department of Biotechnology and Life Sciences, University of Insubria, Varese 21100, Italy
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7
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Ng VY, Louie P, Punt S, Conrad EU. Malignant Transformation of Synovial Chondromatosis: A Systematic Review. Open Orthop J 2017; 11:517-524. [PMID: 28694891 PMCID: PMC5481616 DOI: 10.2174/1874325001711010517] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Revised: 02/20/2017] [Accepted: 02/23/2017] [Indexed: 12/20/2022] Open
Abstract
Background: Synovial chondromatosis (SCh) can undergo malignant transformation. Pathologic diagnosis of secondary synovial chondrosarcoma (SChS) is challenging and misdiagnosis may result in over- or undertreatment. Method: A systematic review revealed 48 cases of SChS published in 27 reports since 1957. Data was collected to identify findings indicative of SChS and outcomes of treatment. Results: At median follow-up of 18 months, patients were reported as alive (10%), alive without disease (22%), alive with disease (15%), dead of disease (19%), dead of pulmonary embolism (4%), and unknown (29%). Initial diagnosis of SChS (grade: low/unknown 48%, intermediate/high 52%) was after biopsy in 58%, local resection in 29%, and amputation in 13%. Seventy-four percent of patients underwent 1.8 (mean) resections. Patients treated prior to 1992 were managed with amputation in 79% of cases compared to 48% after 1992. Symptoms were present for 72 mos prior to diagnosis of SChS. Synovial chondrosarcoma demonstrated symptom progression over several months (82%), rapid recurrence after complete resection (30%), and medullary canal invasion (43%). The SChS tumor dimensions were seldom quantified. Conclusion: Malignant degeneration of synovial chondromatosis is rare but can necessitate morbid surgery or result in death. Pathognomonic signs for SChS including intramedullary infiltration are present in the minority of cases. Progression of symptoms, quick local recurrence, and muscle infiltration are more suggestive of SChS. Periarticular cortical erosion, extra-capsular extension, and metaplastic chondroid features are non-specific. Although poorly documented for SChS, tumor size is a strong indicator of malignancy. Biopsy and partial resection are prone to diagnostic error. Surgical decisions are frequently based on size and clinical appearance and may be in conflict with pathologic diagnosis.
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Affiliation(s)
- Vincent Y Ng
- Department of Orthopaedics, Greenebaum Cancer Center, University of Maryland Medical Center, 110 S. Paca St., 6 Floor, Suite 300, Baltimore, MD 21201, USA
| | - Philip Louie
- Department of Orthopaedics, Rush University Medical Center, Chicago IL, USA
| | - Stephanie Punt
- Department of Orthopaedics, Rush University Medical Center, Chicago IL, USA
| | - Ernest U Conrad
- Department of Orthopedics and Sports Medicine, Seattle Children's Hospital, 4800 Sandpoint Way NE, Seattle, WA 98105, USA
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8
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Raval P, Vijayan A, Jariwala A. Arthroscopic Retrieval of over 100 Loose Bodies in Shoulder Synovial Chondromatosis: A Case Report and Review of Literature. Orthop Surg 2016; 8:511-515. [PMID: 28032713 DOI: 10.1111/os.12294] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2016] [Accepted: 07/16/2016] [Indexed: 01/25/2023] Open
Abstract
Synovial chondromatosis is a rare and benign condition of unknown cause. It is also known as synovial osteochondromatosis. It is characterized by involvement of the synovial tissue, which lines various joints of our body. Initial symptoms range from pain in the joint, locking of the joint at times, especially the knee, to arthritis of the joint that is a late feature of this condition. Although large joints such as the knee are commonly affected, involvement of the shoulder joint is a rare occurrence. Historically an open arthrotomy was preferred for removal of loose bodies coupled with a thorough synovectomy. However, arthroscopy for loose body retrieval has gained popularity over the past two decades. Arthroscopic surgery is an extremely skilled procedure and there is a learning curve for operating in certain anatomical areas such as the shoulder. However, not only does an arthroscopy provide the surgeon with an excellent view of the shoulder but the patient also has a faster recovery. We report a rare case of shoulder synovial chondromatosis in which more than 100 loose bodies were successfully retrieved by an arthroscopy in an individual who had an excellent outcome post-surgery, reaffirming our faith in the procedure. A detailed literature review of arthroscopic procedures is also presented.
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Affiliation(s)
- Pradyumna Raval
- Department of Orthopaedic and Trauma Surgery, Tayside Orthopaedic Rehabilitation Technology Centre, Ninewells Hospital and Medical School, University of Dundee,, Dundee, UK
| | - Ashish Vijayan
- Department of Orthopaedics, Ninewells Hospital and Medical School, Dundee, UK
| | - Arpit Jariwala
- Department of Orthopaedics, Ninewells Hospital and Medical School, Dundee, UK
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9
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Wilson J, Riff AJ, Hellman MD, Sethi S, Jacobs JJ, Gitelis S. A Novel Complication of the Dall-Miles Cable Grip System Mimicking Recurrent Synovial Chondromatosis: A Case Report and Review of the Literature. JBJS Case Connect 2016; 6:e87. [PMID: 29252741 DOI: 10.2106/jbjs.cc.16.00046] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
CASE A 25-year-old man with synovial chondromatosis of the hip was treated with a synovectomy through a transtrochanteric approach; the repair was made with use of a Dall-Miles cable. Approximately 13 years later, the patient returned with a massive bursal reaction and a cyst containing "rice bodies." Although the physical examination and imaging were suggestive of recurrent synovial chondromatosis, the bursal reaction actually represented a novel complication of the Dall-Miles system. CONCLUSION When a patient who has had prior orthopaedic instrumentation presents with pain and imaging that demonstrates formation of a bursal cyst, a cyst containing rice bodies secondary to bursal irritation by the implant should be considered.
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Affiliation(s)
- Jacob Wilson
- Department of Orthopaedic Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Andrew J Riff
- Departments of Orthopaedic Surgery (A.J.R., M.D.H., J.J.J., and S.G.) and Pathology (S.S.), Rush University Medical Center, Chicago, Illinois
| | - Michael D Hellman
- Departments of Orthopaedic Surgery (A.J.R., M.D.H., J.J.J., and S.G.) and Pathology (S.S.), Rush University Medical Center, Chicago, Illinois
| | - Shenon Sethi
- Departments of Orthopaedic Surgery (A.J.R., M.D.H., J.J.J., and S.G.) and Pathology (S.S.), Rush University Medical Center, Chicago, Illinois
| | - Joshua J Jacobs
- Departments of Orthopaedic Surgery (A.J.R., M.D.H., J.J.J., and S.G.) and Pathology (S.S.), Rush University Medical Center, Chicago, Illinois
| | - Steven Gitelis
- Departments of Orthopaedic Surgery (A.J.R., M.D.H., J.J.J., and S.G.) and Pathology (S.S.), Rush University Medical Center, Chicago, Illinois
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10
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Biazzo A, Confalonieri N. Synovial chondrosarcoma. ANNALS OF TRANSLATIONAL MEDICINE 2016; 4:280. [PMID: 27570774 PMCID: PMC4980367 DOI: 10.21037/atm.2016.06.23] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Accepted: 05/24/2016] [Indexed: 12/31/2022]
Abstract
BACKGROUND Synovial chondrosarcoma (SCH) is a very rare tumor arising in the intra-articular cavity. In the majority of literature reports it is described as a malignant transformation of a pre-existing synovial chondromatosis (SC). We reported a systematic review of primary and secondary SCH described in the literature with the aim to recollect data from different case-reports and case-series, trying to summarize general aspects of this very rare disease. METHODS We collected 42 abstracts in the form of case series and case reports, which reported 67 cases of SCH. Studies were taken into account only if they proved a histological diagnosis of SCH, either primary or secondary, with or without evidence of pre-existing SC. RESULTS The average age of SCH was 56.9 years, with prevalence for male sex. The average time of malignant transformation was 11.2 years. The most affected joint was the knee (47.7%), followed by hip (34.3%) and ankle (5.9%). SCH was described as de novo sarcoma only in 13 cases (19%). Surgery ended up with amputation in 59.7% of cases. Local recurrence rate was 28.3%. CONCLUSIONS We concluded that prognosis of SCH is worse than conventional one and we speculated this is due to the difficult site of the tumor (intraarticular), diagnostic delay and inappropriate previous treatments. We consider that a rapid deterioration of a SC or rapid recurrence after synoviectomy should be considered suspicious of malignant transformation and should be treated in a reference center.
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Affiliation(s)
- Alessio Biazzo
- Orthopaedic Department, ASST Gaetano Pini-CTO, via Bignami 1, Milano, Italy
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11
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El Rassi G, Matta J, Hijjawi A, Khair OA, Fahs S. Extra-articular Synovial Chondromatosis Eroding and Penetrating the Acromion. Arthrosc Tech 2015; 4:e443-8. [PMID: 26697302 PMCID: PMC4661792 DOI: 10.1016/j.eats.2015.04.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Accepted: 04/09/2015] [Indexed: 02/03/2023] Open
Abstract
Synovial chondromatosis of the shoulder is an uncommon disorder. It usually affects the glenohumeral joint and is characterized by metaplasia of the synovium leading to the formation of osteochondral loose bodies. Few cases of extra-articular subacromial synovial chondromatosis involving the rotator cuff tendon have been reported in the literature. The treatment of previously reported cases consisted of open bursectomy and removal of loose bodies. We report a case of subacromial synovial chondromatosis without rotator cuff involvement but with severe erosion and fracture of the acromion. Treatment consisted of shoulder arthroscopy to remove all loose bodies, total bursectomy, and debridement of the acromion. Potential benefits of arthroscopy were also evaluated.
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Affiliation(s)
- George El Rassi
- Address correspondence to George El Rassi, M.D., Saint Georges Hospital, PO Box 166378, Ashrafieh, Beirut 1100 2807, Lebanon.
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12
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Xu C, Yang X, Zhao J. Arthroscopic treatment for synovial chondromatosis of the subacromial bursa associated with partial rotator cuff tear. Knee Surg Sports Traumatol Arthrosc 2015; 23:600-2. [PMID: 25217318 DOI: 10.1007/s00167-014-3308-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2014] [Accepted: 09/03/2014] [Indexed: 11/25/2022]
Abstract
UNLABELLED Synovial chondromatosis is characterized by benign synovial proliferation that leads to chondral or osteochondral foci formation. In this case report, a right-handed female suffered from progressively worsening pain and limited mobility of forward elevation, abduction and external rotation in her right shoulder. A shoulder arthroscopy was conducted, during which, thickened bursal synovium and several loose bodies were observed, associated with bursal side tear of rotator cuff. A thorough synovectomy, subacromial debridement and acromioplasty were conducted. The pathological findings were consistent with synovial chondromatosis. After systematic rehabilitation, the patient had relief of shoulder pain and full range of motions in 14-months follow-up. LEVEL OF EVIDENCE Case report, Level IV.
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Affiliation(s)
- Caiqi Xu
- Department of Sports Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai, 200233, China
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13
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Arthroscopic treatment of a case with concomitant subacromial and subdeltoid synovial chondromatosis and labrum tear. Case Rep Orthop 2013; 2013:636747. [PMID: 24383030 PMCID: PMC3872102 DOI: 10.1155/2013/636747] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2013] [Accepted: 11/14/2013] [Indexed: 12/31/2022] Open
Abstract
Synovial chondromatosis is a disease that seldomly seen in shoulder joint and is related to benign synovial proliferation and synchronous chondral tissue formation within the joint cavity. Patients suffer from progressive restriction of range of motion and shoulder pain. Extra-articular involvement is an extremely rare condition. Degenerative osteoarthritis, joint subluxation, and bursitis are common complications in untreated patients. Open or arthroscopic surgery is suitable while there is no consensus related to superiority of different approaches. We presented an arthroscopic treatment of a male patient, 48 years old with labrum tear and synovial chondromatosis localized in subacromial and subdeltoid region. Advantages of arthroscopic surgery in the presence of intra- and extra-articular combined pathologies are also discussed.
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14
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Newman JC, Lustgarten M, Berman KG, Vivrette S, Redding WR. Surgical treatment of synovial osteochondromatosis in the middle carpal joint of a pony. EQUINE VET EDUC 2013. [DOI: 10.1111/eve.12093] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- J. C. Newman
- Department of Clinical Sciences; College of Veterinary Medicine; North Carolina State University; Raleigh North Carolina USA
| | - M. Lustgarten
- Department of Clinical Sciences; College of Veterinary Medicine; North Carolina State University; Raleigh North Carolina USA
| | - K. G. Berman
- Department of Population Health and Pathobiology; College of Veterinary Medicine; North Carolina State University; Raleigh North Carolina USA
| | - S. Vivrette
- Triangle Equine Mobile Veterinary Services; Cary North Carolina USA
| | - W. R. Redding
- Department of Clinical Sciences; College of Veterinary Medicine; North Carolina State University; Raleigh North Carolina USA
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Crawford MD, Kim HT. New-onset synovial chondromatosis after total knee arthroplasty. J Arthroplasty 2013; 28:375.e1-4. [PMID: 22704224 DOI: 10.1016/j.arth.2012.04.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2011] [Accepted: 04/13/2012] [Indexed: 02/01/2023] Open
Abstract
Total joint arthroplasty is commonly recommended as a definitive treatment for synovial chondromatosis refractory to other treatment. We describe a unique case of synovial chondromatosis developing after total joint arthroplasty in a patient presenting 5 years after total knee arthroplasty for osteoarthritis. This case illustrates that the diagnosis of synovial chondromatosis cannot be excluded in a patient with chronic, painful swelling of a joint, even after total joint arthroplasty.
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Affiliation(s)
- Matthew D Crawford
- Department of Orthopaedic Surgery, University of California, San Francisco, California, USA
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16
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Reverté Vinaixa MM, Singh R, Monyart JM, Llado GD, Dominguez MP, Feliu EC, Nardi Vilardaga J, Palou EC. Wrist synovial chondromatosis: case report and literature review. HAND SURGERY : AN INTERNATIONAL JOURNAL DEVOTED TO HAND AND UPPER LIMB SURGERY AND RELATED RESEARCH : JOURNAL OF THE ASIA-PACIFIC FEDERATION OF SOCIETIES FOR SURGERY OF THE HAND 2012; 17:233-8. [PMID: 22745090 DOI: 10.1142/s0218810412720239] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2011] [Revised: 11/19/2011] [Accepted: 11/21/2011] [Indexed: 11/18/2022]
Abstract
Primary synovial chondromatosis is a proliferation of cartilaginous bodies within the synovial membrane, tendon sheath or bursa. It is a rare orthopaedic entity especially when it occurs in the distal radioulnar joint. We report a 27-year-old man with recurrent synovial chondromatosis, nine years after his first operation. Although rare, synovial chondromatosis must be considered in the differential diagnosis in a patient with pain and swelling of the distal radioulnar joint. From our literature review, we report a 17% (5/30) recurrence rate for synovial chondromatosis involving the wrist joint which has not been documented in the medical literature previously.
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Muramatsu K, Miyoshi T, Moriya A, Onaka H, Shigetomi M, Nakashima D, Taguchi T. Extremely rare synovial chondrosarcoma arising from the elbow joint: case report and review of the literature. J Shoulder Elbow Surg 2012; 21:e7-11. [PMID: 21982492 DOI: 10.1016/j.jse.2011.06.014] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2011] [Revised: 06/07/2011] [Accepted: 06/13/2011] [Indexed: 02/01/2023]
Affiliation(s)
- Keiichi Muramatsu
- Department of Orthopedic Surgery, Yamaguchi University School of Medicine, Ube, Yamaguchi, Japan.
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Marengo MF, Suarez-Almazor ME, Lu H. Neoplastic and Paraneoplastic Synovitis. Rheum Dis Clin North Am 2011; 37:551-72. [DOI: 10.1016/j.rdc.2011.09.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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Primary synovial chondrosarcoma of the hip joint in a 45-year-old male: case report and literature review. Skeletal Radiol 2011; 40:1375-81. [PMID: 21562938 DOI: 10.1007/s00256-011-1172-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2011] [Revised: 03/31/2011] [Accepted: 04/05/2011] [Indexed: 02/02/2023]
Abstract
Synovial chondrosarcoma is a rare tumor, seen most commonly arising from antecedent synovial chondromatosis, the more common benign entity. The distinction between the two can be difficult on the basis of clinical, imaging, and histologic criteria. The authors report a case of pathologically proven synovial chondrosarcoma of the hip in a 45-year-old male initially treated for presumed synovial chondromatosis. The case is made more unusual by the fact that no evidence of co-existent synovial chondromatosis was noted at histology. The literature as regards synovial chondrosarcoma, both de novo and secondary cases, is reviewed.
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Nielsen GP, Rosenberg AE, O'Connell JX, Kattapuram SV, Schiller AL. Tumors and diseases of the joint. Semin Diagn Pathol 2011; 28:37-52. [PMID: 21675376 DOI: 10.1053/j.semdp.2011.02.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
A variety of different diseases affect the synovium, including infection, noninfectious immunologic inflammatory conditions, degenerative arthroses, crystal deposits, trauma, and tumors. Tumors of the synovium are relatively uncommon. Any mesenchymal tumor may arise in the synovium, but most recapitulate its normal counterpart including synoviocytes, blood vessels, fat, and fibrous tissue. These tumors can arise in any synovial lined structures both within joints and in extraarticular locations. Most synovial tumors are benign. Malignant tumors are rare but important to recognize because many are aggressive and must be treated appropriately. Among common nonneoplastic conditions that affect the synovium and surrounding structures are crystal deposits such as monosodium urate crystals, calcium pyrophosphate dihydrate crystals, and hydroxyapatite crystals. These crystal deposits may be asymptomatic or cause severe pain or chronic joint destruction. Their accurate identification is important to guide appropriate therapy.
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Affiliation(s)
- G Petur Nielsen
- Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114, USA.
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21
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González-Pérez LM, Congregado-Córdoba J, Salinas-Martín MV. Temporomandibular joint synovial chondromatosis with a traumatic etiology. Int J Oral Maxillofac Surg 2010; 40:330-4. [PMID: 20951553 DOI: 10.1016/j.ijom.2010.09.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2010] [Revised: 04/26/2010] [Accepted: 09/13/2010] [Indexed: 11/29/2022]
Abstract
Synovial chondromatosis (SC) is a metaplastic disorder characterized by the formation of cartilaginous nodules inside the articular space. SC is uncommon in the temporomandibular joint (TMJ). A few reports suggest a correlation between a traumatic episode and the development of SC. The authors describe the diagnosis, treatment and follow-up of a patient with unilateral SC of the left TMJ in conjunction with bony resorption on the mandibular condyle and a clear traumatic etiology. They review and comment on previous reports in the literature.
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Affiliation(s)
- L M González-Pérez
- Department of Oral and Maxillofacial Surgery, Virgen del Rocío University Hospital, Sevilla, Spain
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Abstract
Secondary chondrosarcoma is a distinctive type of tumor that originates from a preexisting cartilaginous lesion. Most commonly, it is associated with solitary or multiple osteochondromas. A fraction of cases arises from other conditions, such as Maffucci syndrome and Ollier disease. A sudden increase in the size of the cartilaginous cap of an osteochondroma is a sign of malignant transformation to secondary chondrosarcoma. However, there is no strict cutoff in terms of thickness of the cartilaginous cap that can be regarded as being pathognomonic of malignancy. Most cases of secondary chondrosarcoma are low to intermediate grade. Distant metastasis is uncommon, and the prognosis is good for most patients. Overall survival at 5 years is approximately 90%. Surgical resection with wide margins is the best treatment option, but local recurrence remains a significant problem in approximately 10% to 20% of patients. Patients with secondary chondrosarcoma of the pelvis are especially at risk for local recurrence.
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Scholl DM, Taddie KL. Asymptomatic synovial chondromatosis of the ankle: an incidental finding. J Foot Ankle Surg 2010; 49:565.e13-7. [PMID: 20851002 DOI: 10.1053/j.jfas.2010.08.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2009] [Accepted: 07/29/2010] [Indexed: 02/03/2023]
Abstract
Synovial chondromatosis is an uncommon, benign lesion of nodular cartilaginous neoplastic development of the synovium that can lead to loose bodies and arthritic degeneration if left untreated. Although very rare, malignant transformation to chondrosarcoma can occur. Primary and secondary forms of synovial chondromatosis also exist, and each has distinct clinical, radiographic, and histologic characteristics. In this article, we describe a case of extensive primary synovial chondromatosis of the ankle that was asymptomatic until just before presentation, and that was treated by means of open synovectomy with excision of the osteochondromatous lesions within the joint.
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Affiliation(s)
- Desiree M Scholl
- Providence Hospital and Medical Center, 16001 W. 9 Mile Road, Southfield, MI 48075, USA.
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Mackenzie H, Gulati V, Tross S. A rare case of a swollen knee due to disseminated synovial chondromatosis: a case report. J Med Case Rep 2010; 4:113. [PMID: 20416049 PMCID: PMC2873448 DOI: 10.1186/1752-1947-4-113] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2009] [Accepted: 04/23/2010] [Indexed: 11/30/2022] Open
Abstract
Introduction A 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 presentation A 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. Conclusions Although 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.
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Affiliation(s)
- Hugh Mackenzie
- Department of Orthopaedics, Ealing Hospital, Uxbridge Road, Southall, Middlesex UB1 3HW, UK.
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Zamora E, Mansor A, Vanel D, Errani C, Mercuri M, Picci P, Alberghini M. Synovial chondrosarcoma: Report of two cases and literature review. Eur J Radiol 2009; 72:38-43. [DOI: 10.1016/j.ejrad.2009.05.029] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2009] [Accepted: 05/04/2009] [Indexed: 11/16/2022]
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Köhler T, Kellermann S, Kipke K, Fruth R, Dahlen C. [Recurrent synovial chondromatosis of the tarsometatarsal joint. Case report and review of literature]. Unfallchirurg 2009; 113:54-8. [PMID: 19629422 DOI: 10.1007/s00113-009-1659-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Primary synovial chondromatosis is a rare and usually monoarticular metaplasia of the synovia. It may recur, but the tendency to malignant transformation is very low. The radiological and histopathological differentiation from low grade chondrosarcoma can be difficult. We present a case report of a 32-year-old male with synovial chondromatosis in the tarsometatarsal joint area, which is an uncommon localization.
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Affiliation(s)
- T Köhler
- Klinik für Unfall-, Wiederherstellungs- und Orthopädische Chirurgie, Städtisches Krankenhaus Dresden-Neustadt, Industriestr. 40, 01129 Dresden.
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