summary Synovial Chondromatosis is a proliferative disease of the synovium associated with cartilage metaplasia that results in multiple intra-articular loose bodies. The condition usually presents in patients between 30 and 50 years of age with localized joint pain, stiffness, and swelling. Diagnosis is made on radiographs in late disease but MRI studies may be required in early disease to show cartilage nodules throughout the joint space. Treatment is usually observation for mild symptoms without restriction in motion. Open or arthroscopic synovectomy and loose body resection is indicated for patients with progressive pain, loss of motion, and reduced function. Epidemiology Demographics usually affects young adults 30-50 years of age 2:1 male to female ratio Anatomic location knee is most common location Etiology Mechanism associated with cartilage metaplasia results in multiple intra-articular loose bodies ranges from synovial tissue to firm nodules of cartilage Genetics occasional chromosome 6 abnormalities have been found Presentation Symptoms slow progression of symptoms pain and swelling pain worse with activity mechanical symptoms including stiffness can occur in the bursa overlying an osteochondroma Physical exam decreased range of motion can have warmth, erythema, or tenderness Imaging Radiographs recommended views standard AP/lateral of affected joint findings variable depending on stage of disease may show stippled calcification MRI initially cartilage nodules are only visible on MRI lobular appearance in later stage, signal drop out consistent with calcification Studies Histology discrete hyaline cartilage nodules in various stages of calcification and ossification chondrocytes mild atypia binucleate cells occasional mitoses Treatment Nonoperative observation indications mild symptoms not affecting range of motion Operative open or arthroscopic synovectomy and loose body resection indications severe symptoms affecting range of motion outcomes treatment is symptomatic but may help prevent degenerative joint changes
QUESTIONS 1 of 4 1 2 3 4 Previous Next Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK (OBQ07.57) What is the preferred treatment of painful synovial chondromatosis of the hip in a young adult as seen in the radiograph in Figure A? QID: 718 FIGURES: A Type & Select Correct Answer 1 Conventional total hip arthroplasty 4% (82/2314) 2 Total hip resurfacing with synovectomy 7% (173/2314) 3 Arthroscopic removal of loose bodies 66% (1528/2314) 4 Femoral CAM lesion osteoplasty 11% (266/2314) 5 600cGy radiation once to affected hip joint 11% (260/2314) L 4 Question Complexity D Question Importance Select Answer to see Preferred Response SUBMIT RESPONSE 3 Review Tested Concept Review Full Topic (OBQ04.197) A 47-year-old man presents with right groin pain. Hip radiograph, CT, arthroscopy, and histology slide are shown in Figures A through D. Which of the following statements is true regarding this condition? QID: 1302 FIGURES: A B C D Type & Select Correct Answer 1 This is a benign metaplastic process which requires wide excision due to the risk of malignant transformation 6% (102/1625) 2 This is a benign metaplastic process which requires symptomatic treatment 72% (1173/1625) 3 This is a benign neoplastic process which requires marginal excision 15% (243/1625) 4 This is a benign neoplastic process which requires intralesional excision and adjuvant chemotherapy 4% (62/1625) 5 This is a malignant neoplastic process which requires hip disarticulation and coverage 2% (36/1625) L 2 Question Complexity D Question Importance Select Answer to see Preferred Response SUBMIT RESPONSE 2 Review Tested Concept Review Full Topic
All Videos (0) Podcasts (1) Pathology⎪Synovial Chondromatosis Orthobullets Team Pathology - Synovial Chondromatosis Listen Now 6:39 min 6/16/2020 187 plays 4.0 (2)