Learning objectives
Describe the pathophysiology and clinical features of primary and secondary synovial chondromatosis.
Describe and demonstrate multimodality-imaging features of synovial chondromatosis.
Describe the complications of primary synovial chondromatosis and their imaging correlates.
Discuss other intra-articular/peri-articular pathologies within the differential diagnosis with relevant distinguishing features on imaging
Background
Synovial chondromatosis refers to the presence of intra-articularcartilaginous loose bodies,
whichmay ormay notbe calcified/ossified.
It is known by several other names,
namely synovial osteochondromatosis,
synovial chondrometaplasia,
articular ecchondrosis and synovial chondrosis.
A distinction should be made between primary and secondary synovial chondromatosis.
It should also be differentiated from other intra-articular conditions,
which may have a similar appearance on imaging.
Primary synovial chondromatosis (PSC)is a relatively uncommon condition,
(incidence of 1:100,000) thattypically affects patients in the third to fifth decades of life.
Men are 2-4 times...
Imaging findings OR Procedure Details
Primary synovial chondromatosis (PSC) imaging findings:
Plain radiograph
This is oftenabnormal in 70% of cases and may demonstrate the following features:
Innumerable intra-articular calcifications of uniform size,
which are evenly distributed throughout the joint Fig. 1 (or less commonly tendon or bursa Fig. 5Fig. 6).
Chondroid ring-and-arc pattern of mineralisation is common,
which can progress and undergo ossification.
In rare cases the chondral bodies can coalesce to form la arger,
conglomerate mineralised mass.
Fig. 4
The joint space should be maintained,
however in chronic disease...
Conclusion
Synovial chondromatosis can have a varied appearance depending on whether it is primary or secondary,
intra or extra-articular or on the phase of the disease.
Plain radiographs,
ultrasound,
CT and MRI have characteristic appearances and in equivocal cases,
biopsy can aid diagnosis particularly if other intra-articular causes are suspected.
References
Murphey MD,
Vidal JA,
Fanburg-Smith JC,
Gajewski DA.
Imaging of synovial chondromatosis with radiologic-pathologic correlation.
Radiographics 2007 27:5,
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McKenzie G,
Raby N,
Ritchie D.
A pictorial review of synovial osteochondromatosis.
Eur Radiol 2008 18:2662-2669.
Evans S,
Boffano M,
Chaudhury S,
Jeys L,
Grimer R.
Synovial chondrosarcoma arising in synovial chondromatosis.
Sarcoma vol 2014.
Rangoako ST,
Raubenheimer EJ,
Mafeelane K.
Synovial chondromatosis: a review of the literature and report of two cases.
SA Orthop J 2015 14(1): 48-51.
Ho YY,
Choueka J.
Synovial chondromatosis of...
Personal Information
Acknowledgements:
Dr Bhavin Upadhyay,
Royal National Orthopaedic Hospital