Translate this page into:
Synovial chondromatosis of knee
*For correspondence: 22, Samachar Apartment, Mayur Vihar Phase 1, Delhi 110 091, India dramite31@gmail.com
This is an open access article distributed under the terms of the Creative Commons Attribution NonCommercial ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non commercially, as long as the author is credited and the new creations are licensed under the identical terms.
This article was originally published by Medknow Publications & Media Pvt Ltd and was migrated to Scientific Scholar after the change of Publisher.
A 25 year old female presented to the department of Orthopedics, Lok Nayak Hospital, Delhi, India in June 2013 with pain and flexion deformity in her right knee. On examination, small nodular tender swelling (3×4 cm) was palpable below patellar tendon. There was no joint line tenderness. Fixed flexion deformity of knee (40 degree) was present. Tests for instability of knee were negative. X-ray knee revealed stippled calcification with loose bodies (Fig. 1a, b). MRI shows an abnormal moderate size nodular mass with low to intermediate signal changes on T1 and T2 weighted images which suggests synovial chondromatosis (Fig. 2a–d). On arthroscopy, the mass was appeared to be originating from synovium surrounding the anterior cruciate ligament (ACL) tibial footprint (Fig. 3a). Gross examination after excising the mass (Fig. 3b) showed conglomerated tissue of size 3×2 cm, constituting numerous nodules of white-gray, translucent hyaline cartilage. Histopathological examination revealed synovial chondromatosis. At one year follow up, patient was asymptomatic, without evidence of recurrence. Synovial chondromatosis is a synovial proliferative disease in which osteocartilaginous metaplasia occurs within the synovial membrane of joints, bursae or tendon sheaths. Chondromatosis arising from ACL synovium is a rare occurrence.
-
(a). Preoperative X-ray knee anteroposterior view showing stippled calcification in loose bodies (arrow). 1(b). Preoperative X-ray knee lateral view showing stippled calcification in loose bodies (arrow).
-
(a). Preoperative MRI scan T1 weighted image (sagittal cut) showing low to intermediate signal nodular mass (arrow). (b). Preoperative MRI scan T2 weighted image (sagittal cut) showing low signal nodular mass (arrow). (c). Preoperative MRI scan stir (short T1 inversion recovery) (d). Preoperative MRI scan post gadolinium enhancement image (sagittal cut) - Heterogenous enhancing nodular mass (arrow).
-
(a). Intraoperative arthroscopy photograph showing excision mass. 3(b). Photograph of mass after excision.
