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Synovial Chondromatosis


Presentation

  • CASE PRESENTATION: A rare case of bilateral synovial chondromatosis of the ankle is reviewed. A 26 year-old male presented with chronic bilateral ankle pain.[mendeley.com]
  • Pain is increased with weight bearing and may also be present at rest. In the secondary form, a history of osteoarthritis, post-traumatic arthritis, or rheumatoid arthritis may be present. Joint effusion may increase with increased activity.[ncbi.nlm.nih.gov]
  • This was the one failure reported by Coolican and Dandy 1 in which the patient presented with a range of movement from 45 to 90 of flexion.[online.boneandjoint.org.uk]
  • […] knee in a 10-year-old girl. ( 28615116 ) Cho HJ...Suh JD 2018 16 Primary synovial chondromatosis of the subtalar joint: case report and review of the literature. ( 28932921 ) Derek Stensby J...Rahimi A 2018 17 Shoulder joint synovial chondromatosis presenting[malacards.org]
  • Synovial Chondromatosis of the Temporomandibular Joint Presenting as an Intracranial Mass. Arch Otolaryngol Head Neck Surg. 1990;116(11):1334–1337. doi:10.1001/archotol.1990.01870110106015 Download citation file: 2019 New![jamanetwork.com]
Inflammation
  • It usually occurs within the rotator cuff tendons of the shoulder, and causes pain and inflammation. This condition occurs more often in females and diabetics. The supraspinatus tendon is most often involved.[medium.com]
Asymptomatic
  • Treatment [ edit ] Asymptomatic patients do not require therapy. Symptomatic patients should undergo arthroscopic or surgical removal of intra-articular bodies.[en.wikipedia.org]
Severe Pain
  • After three arthroscopic synovectomies and removal of loose bodies, an arthrotomy and an open synovectomy, the patient still complained of severe pain and stiffness.[online.boneandjoint.org.uk]
Hypertension
  • Delivery Models Health Care Economics, Insurance, Payment Health Care Policy Health Care Quality Health Care Reform Health Care Safety Health Care Workforce Health Disparities Health Informatics Health Policy Hematology History of Medicine Humanities Hypertension[jamanetwork.com]
Blister
  • In experienced hands, US is also useful for the diagnosis. [1] In the disease, the thin flexible membrane of the synovium gradually forms blisters which calcify and enlarge.[en.wikipedia.org]
Joint Swelling
  • Common signs/symptoms include joint swelling (fluid in the joint), joint pain, difficulty with joint movement and a creaking or popping sensation during movement. Sometimes the nodules can be felt under the skin close to the joint.[nicklauschildrens.org]
  • This usually is coupled with complaints of joint swelling. It most frequently is monoarticular in the primary form and may be multi-articular in the secondary form. Occasionally the patient will experience locking or catching in the joint.[ncbi.nlm.nih.gov]
Joint Effusion
  • Additional radiographic findings include joint effusion and degenerative changes such as joint space narrowing, subchondral sclerosis, and osteophyte formation.[en.wikipedia.org]
  • Joint effusion may increase with increased activity. With increased joint effusions, pain can also increase. Evaluation Radiographic findings enable differentiation of primary from secondary types.[ncbi.nlm.nih.gov]
Arthritis
  • […] to this disease: early: no loose bodies but active synovial disease; transitional: active synovial disease, and loose bodies; late: loose bodies but no synovial disease; In the early stages of the disease it is often confused with tendinitis and/or arthritis[en.wikipedia.org]
  • In the secondary form, a history of osteoarthritis, post-traumatic arthritis, or rheumatoid arthritis may be present. Joint effusion may increase with increased activity. With increased joint effusions, pain can also increase.[ncbi.nlm.nih.gov]
Fracture
  • Differential diagnosis [ edit ] Trauma-related: Fracture with avulsed fragment Fragmentation of meniscus with calcification Degenerative joint disease related: Degenerative joint disease with detached spur Synovial proliferation: Pigmented villonodular[en.wikipedia.org]
  • A manipulation under anaesthetic was performed which resulted in a fracture of the femur. When this had united, the patient was left with 20 of movement in the knee and an arthrodesis was offered.[online.boneandjoint.org.uk]
Osteophyte
  • Additional radiographic findings include joint effusion and degenerative changes such as joint space narrowing, subchondral sclerosis, and osteophyte formation.[en.wikipedia.org]
Vertigo
  • .1990.01870110106015 Full Text • A unique case of synovial chondromatosis of the temporomandibular joint is described that infiltrated the capsule, eroded the petrous portion of temporal bone, and presented as an intracranial mass with facial nerve paralysis, vertigo[jamanetwork.com]
Irritability
  • Symptoms such as joint stiffness and aching are the result of osteoarthritis that sets in after years of persistent joint irritation. Note: Possibility of paralyzation if left too long.[en.wikipedia.org]
Confusion
  • There are 3 defined stages to this disease: early: no loose bodies but active synovial disease; transitional: active synovial disease, and loose bodies; late: loose bodies but no synovial disease; In the early stages of the disease it is often confused[en.wikipedia.org]

Workup

Synovial Cyst
  • They may pass from the main joint cavity into a neighboring synovial cyst. For this reason, a mass may not be appreciated within the actual joint space itself.[en.wikipedia.org]

Treatment

  • You can help by adding to it. ( August 2017 ) Treatment [ edit ] Treatment is frequently by means of removal of the loose bodies and of a partial or full synovectomy (removal of the synovium) Full synovectomy is a moderately major operation and involves[en.wikipedia.org]
  • […] and arthroscopic study of 16 cases. ( 30799132 ) Lee LM...Gu Y 2019 8 Synovial chondromatosis of the hip, a case report and literature review. ( 30923422 ) van der Valk MR...Veen MR 2019 9 Application of a real-time 3-dimensional navigation system for treatment[malacards.org]
  • Synovial Chondromatosis is benign, noncancerous, and usually only requires symptomatic treatment unless the condition is painful. If it is painful, removal of all loose bodies is required, using an open or arthroscopic technique.[medium.com]
  • Treatment [ edit ] Asymptomatic patients do not require therapy. Symptomatic patients should undergo arthroscopic or surgical removal of intra-articular bodies.[en.wikipedia.org]
  • Statistics and Research Methods Stem Cell Transplantation Substance Use and Addiction Surgery Surgical Innovation Surgical Pearls Teachable Moment Technology and Finance The Rational Clinical Examination Tobacco and e-Cigarettes Toxicology Trauma and Injury Treatment[jamanetwork.com]

Prognosis

  • 3 all of whom complained primarily of pain and swelling, and loss of extension was noted in five of 18 knees by Coolican and Dandy. 1 In their case of recurrence and in ours, the stiffness was severe and was the primary complaint, suggesting a poor prognosis[online.boneandjoint.org.uk]
  • Prognosis There is rarely reoccurrence of primary synovial chondromatosis after surgical management with the removal of the loose bodies and partial synovectomy. Reoccurrence has been reported in a case involving the temporal mandibular joint.[ncbi.nlm.nih.gov]

Etiology

  • In these cases, the lesions are found to be in bursal tissue and/or in tenosynovial tissue in proximity to an involved joint. [1] [2] [3] [4] Etiology The etiology of the primary form has not been determined.[ncbi.nlm.nih.gov]
  • […] chondromatosis of the temporomandibular joint. ( 27769739 ) Bai G...Chen M 2017 47 Synovial chondromatosis of the temporomandibular joint: Immunohistochemical examinations regarding the role of insulin-like growth factors and their binding proteins in the etiology[malacards.org]

Epidemiology

  • Epidemiology Men are reported to be affected with synovial chondromatosis up to four times more commonly than women. The knee is most common joint affected.[ncbi.nlm.nih.gov]
Sex distribution
Age distribution

Pathophysiology

  • Pathophysiology X-ray examination reveals irregularly shaped loose bodies within a synovial joint. This number varies anywhere from two or three loose bodies to several dozens.[ncbi.nlm.nih.gov]

Prevention

  • Transplantation Substance Use and Addiction Surgery Surgical Innovation Surgical Pearls Teachable Moment Technology and Finance The Rational Clinical Examination Tobacco and e-Cigarettes Toxicology Trauma and Injury Treatment Adherence United States Preventive[jamanetwork.com]
  • Although the arthrodesis initially provided significant pain relief and functional improvement, it did not prevent recurrence of the synovial chondromatosis. Fig. 1 Sagittal proton density image through the intercondylar region of the right knee.[online.boneandjoint.org.uk]

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