Synovial chondromatosis: a rare cause of knee pain and swelling

<p>Synovial chondromatosis (SC) is a rare, benign, metaplastic, monoarticular disorder of synovial membrane and bursae of large joints. It commonly affects the large joints such as the knee, hips, wrist, ankle and shoulder. Here we report a case of SC of right knee in a 60-year-old female presenting with chief complaints of pain, swelling, restriction of movement in right knee for 1 year after a fall at home. X-ray of right knee revealed multiple calcified loose bodies. The final diagnosis was established by correlating radiologic findings with the histopathology of the excised specimen. Patient was successfully treated by open partial synovectomy of knee using anterior approaches in a single step procedure.</p>

A study on the outcome of arthroscopic synovial biopsy and synovectomy in the management of chronic synovitis of the knee

<p class="abstract"><strong>Background:</strong> Synovitis of the knee can be very difficult to treat especially when the diagnosis remains elusive. Synovitis occurs because of various causes. We assess the patients presenting to our hospital with synovitis of the knee, who underwent arthroscopic synovial biopsy and partial arthroscopic synovectomy and did a review of literature.</p><p class="abstract"><strong>Methods:</strong> This retrospective study included 25 patients with chronic synovitis of the knee presenting to our institution between July 2012 to January 2016. Inclusion criteria were patients presenting with persistent swelling of the knee; not responding to conservative measures. We excluded patients who had recurrent synovitis, patients who had septic arthritis. All patients underwent Arthroscopic synovial Biopsy and partial synovectomy. Preoperative and postoperative VAS score was calculated.<strong></strong></p><p class="abstract"><strong>Results:</strong> In n=6 patients the histopathological diagnosis was Tuberculosis, which improved with Anti tuberculous drug treatment. In n=1 patient the diagnosis was lipoma arborescens, in n=1 patient the diagnosis was plant thorn synovitis, in n=3 patient the diagnosis was Juvenile rheumatoid arthritis; all 5 patients improved with synovectomy and NSAIDS. In n=14 patients the biopsy report came as chronic non-specific synovitis, 8 of these patients did well with arthroscopic synovectomy while the other 6 had a recurrence. The average VAS score improved from 8.8- pre surgery to 4.7 post surgery.</p><p class="abstract"><strong>Conclusions:</strong> Arthroscopic synovial biopsy and synovectomy gives good results in patients with chronic synovitis of the knee. It may be recommended as a treatment for chronic synovitis of the knee, which is not responding to conservative measures of treatment.</p>

Extra- and intra-articular synovial chondromatosis and malignant transformation to chondrosarcoma

SummaryIntra- and extra-articular primary synovial chondromatosis (SC) was observed in a five-year-old, entire male German Shepherd. Thousands of small cartilaginous nodules were removed from the stifle joint as well as from several adjacent muscles. Diagnosis of SC was established based on clinical, radio-graphic and biopsy results. The owner declined to have a new surgery performed for complete nodule removal and partial synovectomy. Nine months after the initial presentation, a proximal pathological intraarticular tibial fracture was observed and malignant transformation to chondrosarcoma was diagnosed after limb amputation. No metastasis was observed after 1.5 years of follow-up.

Pigmented villonodular synovitis of the knee in a child: Case report

Pigmented villonodular synovitis (PVS) is a destructive fibrohistiocytic proliferation with production of villus and nodular protrusions in synovial membrane. A boy, aged 12 years, had a knee injury during a football game with severe pane, swelling, decreased range of motion, and presence of hemarthrosis. Magnetic resonance imaging revealed, in the projection of the suprapattelar recessus, tumefaction of irregular shape; the largest diameter 11x5 cm. Upper pole of tumefaction was partly impressed in m. vastus intermedius. In general endotracheal anesthesia partial synovectomy was done with complete extirpation of tumefaction. The diagnosis of pigmented villonodular synovitis was established histologically. This type of tumefaction is rare in children, but the adequate treatment is necessary because of its aggressive growth with possible bone destruction and propensity of recidivism. The suspicion of malignant neoplasm is often present. Due to various clinical presentation of villonodular synovitis, early detection and adequate treatment is necessary.