Synovial Chondromatosis




CLINICAL SUMMARY


Synovial chondromatosis is a benign synovial disorder resulting in the production of numerous small, intraarticular osteochondral bodies. Treatment, consisting of removal of the bodies and synovectomy, is usually successful. Synovial chondromatosis can also be a secondary finding in degenerative joint disease.




DIAGNOSTIC FEATURES


















History


  • Most common between 20 and 40 years of age



  • Intermittent, sometimes sharp joint pain

Location


  • Monoarticular, synovial neoplasm



  • Distribution in order of frequency: (1) knee, (2) hip, and (3) shoulder and elbow

MRI


  • T2 images show distinctive, multiple, round, intraarticular masses



  • The calcified central portion of the mass has low signal on T1 and T2






IMAGING




























  • Anteroposterior pelvis radiograph demonstrating subtle widening of the medial joint space ( arrow ) and calcifications overlying the obturator foramen ( left ).



  • The CT demonstrates mineralized foci overlying the obturator externus and low-attenuation material ( arrow ) in the joint ( right ).










  • Soft tissue window of a knee CT ( left ) demonstrates low attenuation ( star ) of the nonmineralized cartilage and denser foci of mineralization ( arrow ).



  • CT scan of synovial chondromatosis in the shoulder shows multiple round, calcified bodies ( right ).


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