Synovial Chondromatosis of the Elbow Joint in a 27-Year-Old Man: A Case Report

Fatih Türkmensoy, İsmail Türkmen, Mehmet Salih Söylemez, Yalçın Turhan, Birol Aktaş, Feyza Ünlü Özkan

Department of Orthopaedics and Traumatology, Düzce State Hospital, Düzce, Turkey.
Department of Orthopaedics and Traumatology, G?ztepe Training and Research Hospital, ?stanbul Medeniyet University, ?stanbul, Turkey.
Department of Physical Therapy and Rehabilitation, Fatih Sultan Mehmet Training and Research Hospital, ?stanbul, Turkey..

DOI: 10.4236/ojo.2013.32029                

Abstract

Introduction: Multiple intraarticular loose bodies are pathognomonic for the Synovial chondromatosis. This disorder affects a wide age range from adults to childhood with no sex dominance. Malignant transformation is rare to date, and there are approximately 34 cases in literature about the transformation of synovial chondromatosis to chondrosarcoma. Case: We present case of a 27-year-old patient who had synovial chondromatosis in his elbow. Discussion: Radiographic findings are usually pathognomonic for the diagnosis. Multiple calcified loose bodies can be seen in the joint in radiographs. Computed tomography (CT) optimally depicts the calcified intraarticular fragments and extrinsic bone erosion. However, because the radioopacity cannot be detected in 1/3 of the cases, diagnosis becomes difficult. Treatment modalities include arthroscopic or open extraction of the loose bodies and arthropasty in the presence of severe osteoarthritis. Conclusion: Synovial chondromatosis should be kept in the differential dignosis of the chronic monoarticular pain and painful limitations of the range of motions of the joints.

Keywords

Elbow; Loose Body; Malignant Transformation; Synovial Chondromatosis; Treatment

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	J. X. O’Connell, “Pathology of the Synovium,” American Journal of Clinical Pathology, Vol. 14, No. 5, 2000, pp. 773-784. doi:10.1309/LWW3-5XK0-FKG9-HDRK
[2]	B. L. Sperling, S. Angel, G. Stoneham, V. Chow, A. Mcfadden and R. Chibbar, “Synovial Chondromatosis and Chondrosarcoma: A Diagnostic Dilemma,” Sarcoma, Vol. 7, No. 2, 2003, pp. 69-73.
[3]	M. D. Murphey, J. A. Vidal, J. C. Fanburg-Smith and D. A. Gajewski, “Imaging of Synovial Chondromatosis with Radiologic-Pathologic Correlation,” Raiographics, Vol. 27, No. 5, 2007, pp. 1465-1486. doi:10.1148/rg.275075116
[4]	M. S. Henderson, “Loose Bodies in the Elbow Joint,” JAMA, Vol. 71, No. 3, 1918, pp. 177-180.
[5]	N. Elmali, I. Esenkaya and A. Alkan, “Synovial Chondromatosis: A Report of Four Cases with Three Diverse Localizations,” Acta Orthopaedica et Traumatologica Turcica, Vol. 37, No. 2, 2003, pp. 173-177.
[6]	J. H. Christensen and J. O. Poulsen, “Synovial Chondromatosis,” Acta Orthopaedica Scandinavica, Vol. 46, No. 6, 1975, pp. 919-925. doi:10.3109/17453677508989279
[7]	J. W. Milgram, “Synovial Osteochondromatosis: A Histopathological Study of Thirty Cases,” The Journal of Bone & Joint Surgery, Vol. 59, No. 6, 1977, pp. 792-801.
[8]	P. I.Wuisman, R. J. Noorda and P. C. Jutte, “Chondrosarcoma Secondary to Synovial Chondromatosis. Report of Two Cases and a Review of the Literature,” Archives of Orthopaedic and Trauma Surgery, Vol. 116, No. 5, 1997, pp. 307-311. doi:10.1007/BF00390060
[9]	S. Adiyaman, M. Demirtas and Y. Saglik, “Sinoviyal Kondromatozis,” Artroplasti Artroskopik Cerrahi, Vol. 8, No. 1, 1994, pp. 55-56.
[10]	T. Shpitzer, A. Ganel and S. Engelberg, “Surgery for Synovial Chondromatosis. 26 Cases Followed up for 6 Years,” Acta Orthopaedica Scandinavica, Vol. 61, No. 6, 1990, pp. 567-569. doi:10.3109/17453679008993585