Recurrent synovial chondromatosis in the hand leading to second ray amputation: A case report

Abstract

Introduction

Synovial chondromatosis is a rare, benign metaplasia of the synovium characterized by the formation of cartilaginous nodules. This condition can lead to joint stiffness, pain, and damage. It is most common in the knee but has been described in various joints, including the hand. Due to its low prevalence and nonspecific symptoms, delayed diagnosis may lead to complications such as local invasion, pain, osteoarthritis, and, rarely, malignant transformation. Surgical intervention is often indicated after conservative management fails.

Case report

This report describes the complex case of synovial chondromatosis of the second metacarpophalangeal (MCP) joint in an 18-year-old female. Multiple surgical interventions culminated in amputation of her second ray for definitive management.

Discussion

This case underscores the complexities of diagnosing and managing synovial chondromatosis, particularly in rare locations like the hand. Despite radiographic and pathological evidence, a definitive diagnosis was delayed, contributing to prolonged morbidity. The aggressive and recurring nature of this case highlights the need to consider synovial chondromatosis in refractory hand and finger joint pain, regardless of patient age or gender. Questions remain about whether earlier aggressive intervention could reduce recurrence or if earlier amputation could improve outcomes.

Conclusion

This case highlights the challenges of diagnosing and managing recurrent synovial chondromatosis in the hand. Early recognition and aggressive intervention may prevent prolonged morbidity and functional impairment. Further research is needed to determine whether earlier amputation could improve outcomes in refractory cases.