Synovial Chondromatosis of the Foot and Ankle

2008 ◽  
Vol 29 (3) ◽  
pp. 312-317 ◽  
Author(s):  
Daniel D. Galat ◽  
Duncan B. Ackerman ◽  
Daniel Spoon ◽  
Norman S. Turner ◽  
Thomas C. Shives
Keyword(s):  
Malignant Transformation ◽  
Surgical Excision ◽  
Synovial Chondromatosis ◽  
Loose Body ◽  
Normal Function ◽  
Low Grade ◽  
Foot And Ankle ◽  
Loose Bodies ◽  
Benign Condition ◽  
Institutional Review

Background: Synovial chondromatosis (SC) is a benign condition where the synovial lining of joints, bursae, or tendon sheaths undergoes metaplasia and ultimately forms cartilaginous loose bodies. Synovial chondromatosis of the foot and ankle is exceedingly rare, and outcomes following surgical excision are largely unknown. Materials and Methods: An Institutional Review Board-approved retrospective review of our institution's surgical database from 1970 to 2006 revealed 8 patients with SC of the foot and/or ankle confirmed by pathology. Results: Eight patients (4 female and 4 male) presented with pain, locking, or stiffness. Average age at presentation was 37 (range, 19 to 60) years. Average followup was 9.5 (range, 1 to 31) years. Six patients had involvement of the ankle, and two, the midfoot. Four patients underwent ankle synovectomy with loose body removal, and were pain-free at last followup. One patient underwent excision and midfoot arthrodesis for severe midfoot destruction. Three patients ultimately underwent below knee amputation, one for multiple recurrences and two for malignant transformation to low-grade chondrosarcoma. Conclusion: To our knowledge, this is the largest reported series of patients with SC of the foot and ankle. In half the patients, synovectomy with excision of loose bodies resulted in pain free return to normal function, without recurrence, at last followup. However, recurrence occurred in 3 (37.5%) of 8 patients with subsequent malignant transformation to low-grade chondrosarcoma occurring in 2 patients.

scholarly journals Arthroscopic Management of Synovial Chondromatosis of the Knee Joint

2021 ◽  
pp. 651-656
Author(s):  
V. S. Gowtham ◽  
. Mervinrosario ◽  
Vaishak Bhat
Keyword(s):  
Case Report ◽  
Knee Joint ◽  
Viscous Fluid ◽  
Efficient Method ◽  
Histopathological Examination ◽  
Synovial Chondromatosis ◽  
Left Knee ◽  
Loose Bodies ◽  
Benign Condition ◽  
Arthroscopic Management

Synovial Chondromatosis is a rare and it is a benign condition characterized by multiple cartilaginous nodules in synovial facet spaces. Synovial Chondromatosis affects most commonly the knee joint. This is a case report of a 30-year-old male patient presented with pain and swelling over the left knee joint. On evaluation MRI shows loose bodies, for which he underwent, arthroscopic exploration. Viscous fluid and loose bodies were identified and showed synovial hyperemia. Synovial debridement was done and loose bodies were removed and sent to histopathological examination. The result signify that arthroscopy is efficient method both in diagnostic as well as therapeutic management of synovial chondromatosis.

Anterior and Posterior Arthroscopic Treatment of Primary Synovial Chondromatosis of the Ankle

2020 ◽  
pp. 107110072097096
Author(s):  
Ivan Bojanić ◽  
Mihovil Plečko ◽  
Ana Mataić ◽  
Damjan Dimnjaković
Keyword(s):  
Malignant Transformation ◽  
Case Series ◽  
Synovial Chondromatosis ◽  
Unknown Etiology ◽  
Loose Bodies ◽  
Retrospective Case ◽  
Level Of Evidence ◽  
Patient’S Satisfaction ◽  
Operative Session

Background: Primary synovial chondromatosis (PSC) is a progressive disorder of unknown etiology resulting in formation of multiple loose bodies. If left untreated, it may lead to degenerative changes or malignant transformation to chondrosarcoma. Methods: Seventeen patients who underwent combined posterior and anterior ankle arthroscopy within the same operative session and had histologically confirmed PSC were included in this retrospective study. American Orthopaedic Foot & Ankle Society (AOFAS) Ankle-Hindfoot score was used to evaluate ankle function preoperatively and at a final follow-up. A 3-question survey was used to evaluate patient’s satisfaction at the final follow-up. Results: In 14 patients, loose bodies were found in both compartments of the ankle, in 2 only in the anterior compartment, and in 1 only in the posterior compartment. All patients had evident signs of synovial inflammation in both compartments. The AOFAS Ankle-Hindfoot score increased from the preoperative median score of 65 (range, 29-90) to 95 (range, 65-100) at the final follow-up. Fourteen patients reported they were extremely satisfied with the outcome, 1 was moderately satisfied, and 2 were dissatisfied. No cases of recurrence of synovitis or loose body formation were noted, nor any signs of malignant transformation during the follow-up period. Conclusion: We believe the risk of recurrence of PSC, which is in close relation to malignant transformation, can be minimized by performing a complete synovectomy of the ankle. Our experience and review of literature makes us believe that ankle PSC should be regarded as a whole joint disorder. Performing a combined posterior and anterior arthroscopic procedure within the same operative session should always be considered in patients with ankle PSC. Level of Evidence: Level IV, retrospective case series.

scholarly journals Synovial Chondromatosis of Hip in a Young Patient Salvaged With Mini Arthrotomy Without Hip Dislocation – A Case Report

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Neetin P. Mahajan ◽  
Prasanna Kumar G S ◽  
Ankit Marfatia ◽  
Akash V. Mane ◽  
Akhil Gop ◽  
...  
Keyword(s):  
Case Report ◽  
External Rotation ◽  
Anterior Part ◽  
Hip Dislocation ◽  
Surgical Excision ◽  
Complete Removal ◽  
Synovial Chondromatosis ◽  
Lateral View ◽  
Daily Routine ◽  
Loose Bodies

Introduction: Synovial chondromatosis is a rare, benign disorder of the synovium, which leads to loose body formation due to metaplastic transformation. It presents as multiple cartilaginous bodies in the synovial joints, bursae and in tendon sheaths. The diagnosis often delayed in hip involvement due to insidious onset of symptoms. Surgical management is essential to manage synovial chondromatosis, which includes hip dislocation and debridement, arthroscopic removal or using arthrotomy. Case Report: A 20-year-old male patient presented with complaints of pain in the left hip since 1 year and difficulty in walking for 6 months. On examination, the patient had mild tenderness over the left hip with the restriction of joint movements. He had flexion deformity of 30°, adduction and external rotation deformity of 10 and 15°, respectively. X-ray of the pelvis with both hips anteroposterior and left hip lateral view revealed calcified nodular mass over superior, inferior part of the femoral head, and anterior part of the neck with decreased joint space. As the patient was disabled with pain, stiffness especially restricted flexion and abduction and difficulty in daily routine activities, we planned for surgical excision of the loose bodies. Using lateral approach to the hip, intra-articular loose bodies were removed through arthrotomy without hip dislocation. At present 2-year follow-up, the patient is having full hip range of motion with no difficulty in squatting, sitting cross-legged, and radiological examination showed no evidence of recurrence. The patient is fully satisfied with the chosen treatment and participating in running and other sports. Conclusion: Although hip synovial chondromatosis are rare, early surgical intervention with complete removal of loose bodies, joint distraction for 6 weeks to allow healing, and early initiation of hip physiotherapy helps in getting better outcome even in patients with early stages of hip arthritis. The early surgical interv

scholarly journals Recurrence of Primary Synovial Chondromatosis (Reichel’s Syndrome) in the Ankle Joint following Surgical Excision

2021 ◽  
Vol 2021 ◽  
pp. 1-3
Author(s):  
Thomas Gatt ◽  
Mark Portelli
Keyword(s):  
Surgical Excision ◽  
Synovial Chondromatosis ◽  
Postoperative Recovery ◽  
Strenuous Exercise ◽  
Loose Bodies ◽  
Management Options ◽  
Time Period ◽  
Rare Benign Tumour ◽  
Short Time

Primary synovial chondromatosis, or Reichel’s syndrome, is a rare benign tumour arising from the synovial lining of a joint. We present the case of a 25-year-old male with Reichel’s syndrome of the ankle, with subsequent recurrence following open retrieval of loose bodies. The initial presentation was of lateral malleolus discomfort which limited moderately strenuous exercise. Clinical examination showed a mild effusion and pain on extremes of movement. Imaging confirmed the presence of multiple loose bodies within the anterior and anterolateral recesses of the ankle. Open removal of 27 loose bodies from the joint was performed, with good postoperative recovery. He represented with pain 9 months later, with imaging of the ankle showing reaccumulation of loose bodies to a lesser extent. A trial of conservative management was opted for. Reichel’s syndrome confined to the ankle is an exceedingly rare diagnosis, with few cases reported in the literature. This case saw the recurrence of the disease in a short time period despite successful surgery in the first instance. Management options to treat recurrence include repeat retrieval of foreign bodies, synovectomy, radiotherapy, or arthrodesis. While the prognosis is favourable, a low risk of malignant potential warrants adequate patient follow-up.

scholarly journals Corpo Peritoneal Livre Gigante: Caso Clínico e Revisão da Literatura

2018 ◽  
Vol 31 (5) ◽  
pp. 272
Author(s):  
Rodrigo Oom ◽  
Cátia Cunha ◽  
Vítor Moura Guedes ◽  
Luís Palma Féria ◽  
Rui Maio
Keyword(s):  
Histological Examination ◽  
Treatment Plan ◽  
Surgical Excision ◽  
Loose Body ◽  
Diagnosis And Treatment ◽  
Pelvic Cavity ◽  
Loose Bodies ◽  
Proper Diagnosis

Peritoneal loose bodies are usually diagnosed incidentally. Only a few cases are documented in the literature. The pathophysiology of this condition is not fully known and its origin may possibly be related to the twisting and separation of epiploic appendages. The authors describe the case of a patient with a spherical solid lesion 6 cm in diameter, identified incidentally in the pelvic cavity of a 64 year old man. The patient underwent laparotomy and a free ovoid shaped white body was identified. Histological examination described a calcified and encapsulated mass with a steato-necrosis core. A review of all cases of giant peritoneal loose bodies described in the literature is included. Surgical excision is recommended when the giant peritoneal loose body diagnosis is uncertain or when they are symptomatic. Doctors should be aware of its existence in order to establish a proper diagnosis and treatment plan.

scholarly journals Synovial chondromatosis of the temporomandibular joint with 400 loose bodies: a case report and literature review

2021 ◽  
Vol 49 (3) ◽  
pp. 030006052110005
Author(s):  
Wenyan Zhao ◽  
Yan Ruan ◽  
Wentao Zhang ◽  
Fan Yang
Keyword(s):  
Case Report ◽  
Temporomandibular Joint ◽  
English Language ◽  
Delayed Diagnosis ◽  
Synovial Chondromatosis ◽  
Small Space ◽  
Loose Bodies ◽  
Benign Condition ◽  
Diagnostic Approaches ◽  
Language Literature

Synovial chondromatosis (SC) is a benign condition characterized by the formation of metaplastic cartilage in the synovial membrane of the joint, resulting in numerous attached and unattached osteocartilaginous bodies. SC mostly affects the large synovial joints, especially the knee, hip, elbow, and ankle, whereas involvement of the temporomandibular joint (TMJ) is rare. Approximately 240 cases of SC of the TMJ have been reported in the English-language literature to date. The number of loose bodies varies among patients but usually ranges from the dozens to around 100. We herein report a case of SC of the TMJ accompanied by approximately 400 loose bodies in a healthy 53-year-old woman. Such a high number of loose bodies within a small space is extremely rare. We also include a brief discussion about the differential diagnoses and current diagnostic approaches to SC of the TMJ. Notably, delayed diagnosis or misdiagnosis is common because of the nonspecific nature of the presenting complaints.

scholarly journals A Rare Case of Primary Synovial Chondromatosis of the Ankle

2016 ◽  
Vol 3 (1) ◽  
pp. 53-55 ◽  
Author(s):  
Viswanathan Chathoth ◽  
Sriram Sankaranarayanan
Keyword(s):  
Ankle Joint ◽  
Male Patient ◽  
Rare Case ◽  
Synovial Chondromatosis ◽  
Loose Body ◽  
Asia Pacific ◽  
X Rays ◽  
Synovial Lining ◽  
Loose Bodies ◽  
History Of

ABSTRACT Synovial chondromatosis is a condition where the synovial lining of joints, tendons, or bursa undergoes metaplasia into cartilaginous loose bodies. Primary synovial chondromatosis of the ankle joint is very rare and less commonly reported in literature. We report a case of primary synovial chondromatosis of the ankle that we encountered in our clinic. A 33-year-old male patient presented with a history of multiple swellings around his right ankle joint, along with dull aching pain. Both the clinical examination and X-rays were suggestive of primary synovial chondromatosis of the ankle. We performed an open loose body removal and synovectomy of the ankle. Histopathology confirmed the diagnosis of primary synovial chondromatosis. We report this case owing to its rarity of presentation. How to cite this article Chathoth V, Sankaranarayanan S. A Rare Case of Primary Synovial Chondromatosis of the Ankle. J Foot Ankle Surg (Asia-Pacific) 2016;3(1):53-55.

scholarly journals A COMBINATION OF PIGMENTED VILLONODULAR SYNOVITIS AND SYNOVIAL CHONDROMATOSIS PRESENTING AS A LARGE LOOSE BODY IN KNEE

2012 ◽  
Vol 02 (03) ◽  
pp. 45-48
Author(s):  
Siddharth Shetty ◽  
Vikram Shetty ◽  
B. J.P. Shetty ◽  
Shubha P. Bhat
Keyword(s):  
Full Range ◽  
Synovial Chondromatosis ◽  
Loose Body ◽  
Pigmented Villonodular Synovitis ◽  
Uneventful Recovery ◽  
Villonodular Synovitis ◽  
Loose Bodies ◽  
Knee Movement ◽  
Pigmented Villonodular

AbstractIntra-articular calcific lesions of knee usually manifest as loose bodies with symptoms of recurring episodes of locking and restriction of movement. These loose bodies are a consequence of trauma or degeneration of structures in the joint and occasionally may be of inflammatory or neoplastic condition of the synovium.Here we present our case as a rare form of presentation where in our patient had a large loose body in the knee with chronic pain and swelling and restriction of the movements of knee. Arthrotomy, loose body excision and total synovectomy of the knee confirmed coexistence of a dual lesion of synovial chondromatosis of the Hoffa's fat pad with diffuse pigmented villonodular synovitis of the knee joint. The patient made an uneventful recovery and full range of knee movement was restored by end 3 months. These benign conditions have inherent risk of recurrence, and in our case, till the last follow up at 14 months after surgery, he has remained asymptomatic with no clinico radiological evidence of any recurrence.

scholarly journals Molecular Landscape for Malignant Transformation in Diffuse Astrocytoma

2021 ◽  
Author(s):  
Thara Tunthanathip ◽  
Surasak Sangkhathat ◽  
Kanet Kanjanapradit
Keyword(s):  
Malignant Transformation ◽  
Extent Of Resection ◽  
Low Grade ◽  
Diffuse Astrocytoma ◽  
Continuous Variables ◽  
Isocitrate Dehydrogenase 1 ◽  
Molecular Alteration ◽  
Exact Test ◽  
Molecular Abnormalities ◽  
Biological Variables

Abstract Background Malignant transformation (MT) of low-grade gliomas changes dramatically the natural history to poor prognosis. Currently, factors associated with MT of gliomas have been inconclusive, in particular, diffuse astrocytoma (DA). Objective The present study aims to explore the molecular abnormalities related to MT in the same patients with different MT stages. Methods Twelve specimens from five DA patients with MT were genotyped using next-generation sequencing (NGS) to identify somatic variants in different stages of MT. We used cross-tabulated categorical biological variables and compared the mean of continuous variables to assess for association with MT. Results Ten samples succussed to perform NGS from one male and four females, with ages ranging from 28 to 58 years. The extent of resection was commonly a partial resection following postoperative temozolomide with radiotherapy in 25% of cases. For molecular findings, poly-T-nucleotide insertion in isocitrate dehydrogenase 1 (IDH1) was significantly related to MT as a dose–response relationship (Mann–Whitney's U test, p = 0.02). Also, mutations of KMT2C and GGT1 were frequently found in the present cohort, but those did not significantly differ between the two groups using Fisher's exact test. Conclusion In summary, we have identified a novel relationship between poly-T insertion polymorphisms that established the pathogenesis of MT in DA. A further study should be performed to confirm the molecular alteration with more patients.

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