Synovial chondromatosis in unusual locations treated with arthroscopy: A report of three cases

Abstract

Synovium holds proliferative properties which may in some cases result in abnormal production of small clumps or nodules of hyaline cartilage. These nodules eventually break free from synovial tissue in time and become loose bodies with varying sizes in the joint. While smaller bodies lead to locking symptoms in the joint, larger ones cause mechanical erosion of the cartilage. Knee is the most commonly affected joint followed by hip.[1] There are also reports about wrist, elbow and, far less commonly, shoulder and ankle joint involvement.[2-4] The classical approach would be arthrotomy and synovectomy, but owing to advancements in arthroscopic techniques and instrument design, arthroscopy has emerged as a viable option in recent years.[3,4] Although arthroscopy is a much less invasive technique with faster recovery Synovial chondromatosis (SC) rarely occurs in the shoulder and ankle joints. An intervention is necessary, as irreversible cartilage injury or transformation to chondrosarcoma may occur. Offering advantages such as faster recovery and lower rates of complication, arthroscopic techniques can be considered instead of open surgery. Herein, we describe three cases of SC, one in shoulder and two in ankle joints. Patients were young adult males and all underwent arthroscopic excision and two had synovectomy. At 18 months of follow-up there was no recurrence and no malignancy and symptoms were alleviated in all patients. In conclusion, arthroscopic removal of all loose bodies and synovectomy in primary SC can be regarded as a safe and effective treatment with low morbidity, rapid recovery, and good outcomes. Histological confirmation of the diagnosis is necessary as malignant transformation is possible.