Synovial chondromatosis of the hip when symptomatic is treated by removal of the loose bodies with synovectomy, chondroplasty, and labral debridement as needed. Synovial chondromatosis is a painful synovial proliferative disorder that is associated with cartilage metaplasia that results in multiple intra-articular loose bodies. It most often occurs in young adults who present with pain, stiffness, and swelling. Radiographs usually show fine, stippled, intra-articular calcifications, as we see here, characteristic of partially calcified cartilage granules. In a young adult with preserved joint space an arthroplasty is not recommended.
A case series by Marchie et al of 29 patients with synovial chondromatosis treated by hip arthroscopy found benefit especially in cases with early grade cartilage changes.
Illustration A demonstrates arthroscopic evaluation and removal of loose bodies associated with synovial chondromatosis.
Dorfman HD, Czerniak B: Bone Tumors. St Louis, MO, Mosby, 1998, pp 1041–78
Marchie A, Panuncialman I, McCarthy JC. Efficacy of hip arthroscopy in the management of synovial chondromatosis. Am J Sports Med. 2011 Jul;39 Suppl:126S-31S.
PMID:21709042 (Link to Abstract)