Incidental findings involving the temporomandibular joint on computed tomography and magnetic resonance imaging

The temporomandibular joint (TMJ) is frequently imaged in head and neck computed tomography (CT) and magnetic resonance imaging (MRI) studies. Depending on the indication for the study, an abnormality of the TMJ may be an incidental finding. These findings encompass both intra- and extra-articular disorders. They may also be related to local, regional or systemic conditions. Familiarity with these findings along with pertinent clinical information helps narrow the list of differential diagnoses. While definitive diagnosis may not be immediately apparent, a systematic approach contributes to improved discussions between clinicians and radiologists and better patient management.

Synovial chondromatosis of the hip was misdiagnosed as rice body bursitis: a case report / 中华骨科杂志

This study shows a case of a patient with synovial chondromatosis of the hip misdiagnosed as rice body bursitis. The patient complained of pain and limited activity in his left hip. He was diagnosed with synovial chondromatosis of the hip by medical history, physical examination, imaging examination and postoperative pathology. Based on literature review, the characteristics and differential diagnosis of the disease in epidemiology, imaging and pathology were discussed in detail, so as to improve the understanding of the disease and avoid misdiagnosis. He was treated with hip arthroscopy and obtained satisfactory therapeutic effect. The patient was followed up for 1 year without recurrence.

Clinical analysis of arthroscopy used in the diagnosis and treatment of synovial chondromatosis of the temporomandibular joint / 华西口腔医学杂志

OBJECTIVES@#To evaluate the value of arthroscopy in the diagnosis and treatment of synovial chondromatosis of the temporomandibular joint (TMJSC).@*METHODS@#The cases of 16 patients preliminarily diagnosed with TMJSC by magnetic resonance imaging (MRI) from July 2011 to December 2018 were analyzed retrospectively. If the diagnosis was confirmed by arthroscopy, the opening operation was performed. The preoperative MRI, arthroscopy and opening operation, postoperative pathology and postoperative MRI of confirmed cases were analyzed, and clinical follow-up was performed to evaluate the curative effect of open surgery. The degree of mouth opening and visual analogue scale (VAS) scores for pain pre-operation and during follow-up of the confirmed cases were analyzed by @*RESULTS@#Fourteen cases of TMJSC were diagnosed by arthroscopy, consistent with the postoperative pathological diagnosis. Postoperative MRI examination showed that articular cavity lesions basically disappeared. Ten patients with synovial chondromatosis were followed-up (follow-up rate, 71.4%) from 6 months to 7 years and 8 months (average follow-up time, 17.6 months); no recurrence was found, and clinical symptoms improved by varying degrees. Before operation and at follow-up, @*CONCLUSIONS@#Arthroscopy is essential in the diagnosis and treatment of TMJ synovial chondromatosis.

Osteocondromatosis sinovial de hombro. Una enfermedad poco frecuente / Shoulder synovial osteocondromatosis. A rare disease

RESUMEN La osteocondromatosis sinovial es una condición poco común que se caracteriza por la formación de nódulos cartilaginosos u óseos comúnmente visto en las articulaciones sobretodo en la rodilla, sin embargo en el hombro esta condición es rara. Presentamos un caso clínico de una mujer de 35 años de edad con dolor en hombro izquierdo de larga evolución, tratado de manera conservadora antes de ser referido a un ortopedista. Luego de un diagnostico clínico y radiológico se sometió a tratamiento quirúrgico en la que se realizó un desbridamiento y escisión de los cuerpos condrales con éxito. Palabras claves: Condromatosis sinovial, tratamiento, adulto joven, mujer

ABSTRACTSynovial osteochondromatosis is a rare condition characterized by the formation of cartilage or bone nodules commonly seen in the joints, especially in the knee, however, this condition is rare in the shoulder. We present a clinical case of a 35-year-old woman with a long history of left shoulder pain, treated conservatively before being referred to an orthopedist. After a clinical and radiological diagnosis, she underwent surgical treatment in which a successful debridement and excision of the chondral bodies was performed

Osteocondromatosis sinovial de rodilla: una causa infrecuente de gonalgia en edad pediátrica / Synovial chondromatosis of the knee. A rare cause of knee pain in pediatric age

La osteocondromatosis sinovial es una metaplasia benigna de la membrana sinovial que afecta a 1 de cada 100 000 personas, en su mayoría adultos, y es extremadamente infrecuente en edad pediátrica. Predomina en grandes articulaciones, sobre todo la rodilla, y la sintomatología es, por lo general, inespecífica. Dado que la radiografía simple no suele ser concluyente, se recurre a la resonancia magnética nuclear y a la tomografía axial computarizada para orientar el diagnóstico. Se expone el caso de una paciente de 10 años de edad con gonalgia y dismorfia en la patela izquierda de seis meses de evolución, con diagnóstico de osteocondromatosis sinovial. Se presenta el caso dado que se trata de una entidad muy rara en niños, pero que requiere un tratamiento quirúrgico precoz para evitar sus posibles complicaciones, como la destrucción articular progresiva o la malignización a condrosarcoma.

Synovial osteochondromatosis consists of a synovial metaplasia which affects 1 per 100 000 people. It is a very rare disease among children. It typically affects large joints of the body, especially the knee. Due to the lack of specificity of the signs and symptoms and X-Ray images, imaging tests such as nuclear magnetic resonance or computerized tomography are frequently needed for diagnosis.We report a case of a ten-year-old female patient with a six months history of pain and deformity of left patella which was diagnosed with synovial osteochondromatosis. This case highlights the importance of clinical suspicion, not only because it is an extremely rare disease in children, but also because it needs a surgical treatment as soon as possible in order to avoid consequences it might have in pediatric age, as joint destruction or malignization to chondrosarcoma.

Synovial chondromatosis of temporomandibular joint with disc perforation: A case report and literature review / 吉林大学学报(医学版)

Objective: To analyze the clinical manifestations, pathogenesis, auxiliary examinations, differential diagnosis and treatment methods of the patient with synovial chondromatosis of temporomandibular joint (TMJSC) with disc perforation, and to provide the basis for the diagnosis and treatment of TMJSC∗ patients. Methods: The clinical data of one patient with TMJSC∗ were collected, and the diagnosis and treatment process was analyzed, and the related literatures were reviewed. Results: The female 53-year-old patient was admitted to hospital due to occasional tenderness in the right TMJ for more than 1 year. The computerized tomography (CT) results revealed that the changes could be found around the wall of maxillary sinus and the joint. The magnetic resonance imaging (MRI) results showed the diffused nodular, low and equal signals in the joint cavity, the shadow of fluid signals in the joint cavity was increased, and the joint space was broadened. The open surgery was performed in the patient successfully, including the removal of loose bodies and synovectomy, and the pathology result after opration was synovial chondromatosis (SC). No recurrence was found during 6 months after follow-up. Conclusion: The histopathology examination assisted with CT and MRI should be perfomed in the diagnosis of TMJSC. Surgical treatment is an effective method, and the pathological diagnosis is the gold standard for TMJSC.

Clinical Results of Surgical Resection and Histopathological Evaluation of Synovial Chondromatosis in the Shoulder: A Retrospective Study and Literature Review

BACKGROUND: Synovial chondromatosis occurs rarely in the shoulder, and its details remain unclear. The purpose of this study was to clarify the clinical results of surgical resection and the histopathological findings of synovial chondromatosis in the shoulder.METHODS: Ten shoulders with synovial chondromatosis that had been operatively resected were reviewed retrospectively. Osteochondral lesions were present in the glenohumeral joint in six shoulders and in the subacromial space in four shoulders. Two patients had a history of trauma with glenohumeral dislocation without recurrent instability, and the other seven patients (eight shoulders) did not have any traumatic episodes or past illness involving the ipsilateral shoulder girdle. The occurrences of osteochondral lesions, inferior humeral osteophytes, and acromial spurs were assessed on radiographs before resection, just after resection, and at final follow-up. The Constant scores were compared before resection and at final follow-up with Wilcoxon signed-rank tests. Resected lesions were histopathologically differentiated between primary and secondary synovial chondromatosis.RESULTS: Inferior humeral osteophytes were found in five shoulders with synovial chondromatosis in the glenohumeral joint, and all four shoulders with synovial chondromatosis in the subacromial space had acromial spur formation. Osteochondral lesions appeared to have been successfully removed in all shoulders on postoperative radiographs. At the final follow-up, however, one shoulder with secondary synovial chondromatosis in the subacromial space showed recurrence of osteochondral lesions and acromial spur formation. The mean Constant score improved significantly from 53.0 points before resection to 76.0 points at a mean follow-up of 6.0 years (p = 0.002). On histopathological evaluation, one shoulder was diagnosed as having primary synovial chondromatosis, while nine shoulders had secondary synovial chondromatosis.CONCLUSIONS: The present study showed that resection of shoulder osteochondral lesions successfully relieved the clinical symptoms and that primary synovial chondromatosis is less common than secondary synovial chondromatosis in the shoulder. Although most of the present osteochondral lesions were clinically determined to be primary chondromatosis, only one case was histopathologically categorized as primary synovial chondromatosis. These results suggest that histopathological identification is needed to differentiate between primary and secondary synovial chondromatosis.

Expression of cartilage oligomeric matrix protein in the synovial chondromatosis of the temporomandibular joint / 北京大学学报(医学版)

OBJECTIVE@#To detect the expression of cartilage oligomeric matrix protein (COMP) in the synovial chondromatosis of the temporomandibular joint (TMJSC), and to discuss the possible interactions between COMP, transforming growth factor (TGF)-β3, TGF-β1 and bone morphogenetic protein-2 (BMP-2) in the development of this neoplastic disease.@*METHODS@#Patients in Peking University School and Hospital of Stomatology from January 2011 to February 2020 were selected, who had complete medical records, TMJSC was verified histologically after operation. The expressions of COMP, TGF-β3, TGF-β1 and BMP-2 in the TMJSC of the temporomandibular joint were detected by immunohistochemistry and quantitative real-time PCR (RT-PCR) at the protein level and mRNA level respectively, compared with the normal synovial tissue of temporomandibular joint. The histological morphology, protein expression and distribution of TMJSC tissues were observed microscopically, and the positive staining proteins were counted and scored. SPSS 22.0 statistical software was used to analyze the expression differences between the related proteins in TMJSC tissue and the normal synovial tissue of temporomandibular joint and to compare their differences. P < 0.05 indicated that the difference was statistically significant.@*RESULTS@#Immunohistochemical results showed that the positive expression of COMP in TMJSC tissues was mostly found in synovial tissues and chondrocytes adjacent to synovial tissues, and the difference was statistically significant, compared with the normal temporomandibular joint synovial tissues. The positive expression of COMP was significantly different between recurrent TMJSC and non-recurrent ones. The positive expressions of TGF-β3, TGF-β1 and BMP-2 were higher than the normal synovial tissue, and were also mostly found in the synovial cells and adjacent chondrocytes, which was further confirmed by Western blot. According to the RT-PCR results, the expressions of COMP, TGF-β3, TGF-β1 and BMP-2 in TMJSC were higher than those in the normal synovial tissue.@*CONCLUSION@#The expression of COMP in TMJSC of temporomandibular joint increased significantly, compared with the normal synovial tissue. There may be interactions between COMP and cytokines related to the proliferation and differentiation, like TGF-β3, TGF-β1 and BMP-2, which may play a potential role in the pathogenesis of TMJSC.

Surgical treatment of a rare bilateral synovial chondromatosis

Synovial chondromatosis (SC) in the temporomandibular joint (TMJ) is an uncommon entity, mostly when the involvement is bilateral. The authors report a rare case of bilateral SC, with a follow-up of 13 months, and a literature review. A 60-year-old Caucasian woman, with the chief complaint of pain for 6 years in the bilateral pre-auricular region, had a progressive clacking and discomfort on the left side during mouth opening. The panoramic image was suggestive of SC. The bilateral lesion was surgically removed by direct access. Histopathological examination confirmed the clinical diagnosis of bilateral SC. This article shows the importance of a multidisciplinary approach for the early diagnosis and appropriate treatment. Also, it encourages the referral of such cases to professionals with a greater familiarity with this entity.

Condromatosis Sinovial Primaria de la Articulación Temporomandibular con Extensión a Hueso Temporal. Reporte de un Caso y Revisión de la Literatura / Primary Synovial Chondromatosis of the Temporomandibular Joint with Temporal Bone Extension. Case Report and Literature Review

RESUMEN: La condromatosis sinovial (CS), es una lesión benigna poco frecuente y de clínica bastante inespecífica. Suele afectar articulaciones de huesos largos como la rodilla, el codo y la cadera, presentándose generalmente de manera unilateral. Se cree que solo un 3 % de los casos de CS afecta la articulación temporomandibular. Esta condición se caracteriza por ser un trastorno metaplásico del tejido conectivo sinovial que suele manifestarse con la formación de pequeños y múltiples nódulos de cartílago que posteriormente pueden desprenderse, calcificarse y formar cuerpos libres dentro del espacio articular. Presentamos el caso de una mujer de 55 años con condromatosis sinovial de la articulación temporomandibular, tratada desde hace 3 años bajo el diagnóstico de desórdenes temporomandibulares. A pesar de ser considerada una lesión de tipo benigna, esta puede llegar a ser localmente agresiva, extendiéndose como en nuestro reporte hacia la fosa craneal media, adelgazando parte del hueso temporal.

ABSTRACT: Synovial chondromatosis (CS) is a benign lesion that is rare and clinically quite nonspecific. It usually affects the joints of long bones such as the knee, elbow and hip, usually occurring unilaterally. It is believed that in only 3 % of cases of CS the temporomandibular joint. This is a condition its characterized by being a metaplastic synovial connective tissue that manifests itself with the formation of small and multiple cartridges that detach, calcify and form free bodies within the joint space. We present the case of a 55-year-old woman with synovial chondromatosis of the temporomandibular joint, treated for 3 years under the diagnosis of temporomandibular disorders. Despite being considered a benign lesion, this can become locally aggressive, extending as in our report to the cranial fossa, thinning part of the temporal bone.

Extensive Synovial Chondromatosis Involving All Flexor Tendons in the Tarsal Tunnel: A Case Report / Condromatose sinovial extensa envolvendo todos os tendões do túnel do tarso: relato de caso

Abstract Synovial chondromatosis is a rare condition characterized by benign chondrogenic metaplasia of extra-articular synovial tissue. It usually affects a single tendon sheath of the hand or foot. This report describes a rare case with extensive synovial chondromatosis affecting all flexor tendons in the tarsal tunnel, its radiological features, surgical treatment, and clinical outcome. The authors present a unique case of extensive synovial chondromatosis in a 48-year-old male involving the tendon sheaths of the flexor hallucis longus, flexor digitorum longus, and posterior tibialis tendons, at the level of the tarsal tunnel, with extension into the plantar aspect of the foot. The patient initially presentedwith symptoms of tarsal tunnel compression and was found to have a 4-cm mass in the posteromedial aspect of the ankle. The presumptive diagnosis of synovial chondromatosiswasmadebased on radiographic and magnetic resonance imaging evidence. The patient underwent surgical resection of the tumor, aswell as tarsal tunnel releaseandgastrocnemius recession. The diagnosiswas confirmed postoperatively by surgical histopathology. The postoperative course of the patient was uncomplicated and his tarsal tunnel symptoms resolved. This represents a case of extensive synovial chondromatosis involving all flexor tendons in the tarsal tunnel that was correctly diagnosed by clinical and imaging findings, which required early surgical resection to avoid long-term neurovascular complications.

Resumo A condromatose sinovial é uma condição rara caracterizada por metaplasia condrogênica benigna do tecido sinovial extra-articular, que geralmente afeta uma única bainha tendínea da mão ou do pé. O objetivo é relatar o caso raro de um paciente com diagnóstico de condromatose sinovial extensa afetando todos os tendões flexores na topografia do túnel do tarso, suas características radiológicas, tratamento cirúrgico e desfecho clínico. Os autores apresentam um caso único de condromatose sinovial extensa em um homem de 48 anos envolvendo as bainhas dos tendões flexor longo do hálux, flexor longo dos dedos e tibial posterior, na topografia do túnel do tarso, com extensão para a região plantar do retropé. O sintoma inicial foi de compressão neurovascular (síndrome do túnel do tarso). A suspeita diagnóstica foi condromatose sinovial com base em evidências radiográficas e de ressonância magnética. O paciente foi submetido a ressecção cirúrgica do tumor, bem como a liberação do túnel tarsal e alongamento do tendão dos gastrocnêmios. O diagnóstico foi confirmado por exame histopatológico do espécime colhido no período intraoperatório. A evolução pósoperatória do paciente ocorreu sem complicações e os sintomas da síndrome do túnel do tarso cessaram. Os autores relatam um caso de condromatose sinovial extensa envolvendo todos os tendões flexores do túnel do tarso, corretamente diagnosticado por achados clínicos e radiológicos e que necessitou de ressecção cirúrgica precoce para evitar complicações neurovasculares em longo prazo.

Synovial chondromatosis of temporomandibular joint: a case report and literature review / 口腔疾病防治

Objective@#To explore the diagnosis, treatment and prognosis of synovial chondroma in the temporomandibular joint and to provide a reference for clinical diagnosis and treatment.@*Methods @#A case of right temporomandibular joint synovial chondromatosis admitted to the Stomatological Hospital, Southern Medical University was reported, and the related literature was reviewed and analyzed.@*Results @#During the movement of the mandibular opening, noise and obvious pain were found. The imaging features showed that several free calcification shadows of different sizes were seen around the condyle in the right articular fossa. The right temporomandibular joint mass resection and articular disc reduction were performed under general anesthesia, and the postoperative pathological results showed synovial chondromatosis. The patient′s symptoms were relieved 3 months after the surgery, and the imaging examination showed no residual lesions. A review of the literature shows that synovial chondromatosis usually occurs in large joints, such as the knee, hip, elbow, and shoulder joints, and rarely occurs in the temporomandibular joint. It occurs in middle-aged patients, manifesting as pain, swelling, and limited movement. Imaging studies play an important role in diagnosis, but the final diagnosis requires pathological diagnosis. Surgical treatment is effective, and synovial chondromatosis does not easily relapse.@*Conclusion@#The diagnosis of TMJ synovial chondroma should be combined with clinical manifestations, imaging features, and pathological examination. Surgery is an effective treatment. After completely removing the diseased and affected tissues, the disease has a good prognosis and does not easily relapse.

Synchronization of Synovial Chondromatosis and Mycobacterium intracellurae Infection in Olecranon Bursitis: A Case Report

A 73-year-old woman presented with a recurrent cystic mass around her left olecranon. She had a history of 8 steroid injections due to elbow pain beginning 3 years ago and twice had undergone aspiration of olecranon bursitis that developed two months prior to presentation. She had been taking medications for hypertension and diabetes with no pertinent past history. On magnetic resonance imaging (MRI), there were multiple nodules in the olecranon bursa, which were isointense to muscle on T1-weighted images and hyperintense to muscle on T2-weighted images. Our initial diagnosis was synovial chondromatosis. On bursoscopy, masses of gray-white colored nodules were observed in the bursa. Finally, synovial chondromatosis and non-tuberculous mycobacterial infection were concurrently diagnosed. In conclusion, uncalcified synovial chondromatosis and rice bodies can have similar visual and MRI characteristics; therefore, we suggest that clinicians should be aware of the possibility of other infections in cases of this type.

Arthroscopic treatment of synovial chondromatosis of the ankle / Tratamento artroscópico de condromatose sinovial do tornozelo

ABSTRACT Synovial chondromatosis is a rare proliferative disease, characterized by the occurrence of metaplasia in the synovium of the joints. These lesions become pedunculated; with the evolution of the disease they become detached, leading to intra-articular loose-bodies. It occurs more frequently in males between the third and fifth decades of life, usually affecting large joints such as the knee and hip. Smaller joints, such as the ankle, are less frequently affected. Patients report articular pain, blockage, and limited range of motion caused by the loose fragments. As the disease progresses, the joint undergoes degenerative changes. This report describes a case of synovial chondromatosis of the ankle, treated by arthroscopy. The patient, a 59 year-old male, complained of pain and swelling of the left ankle. Physical evaluation showed limited tibiotarsal mobility (plantar flexion of 20° and dorsiflexion of 5°). After physical and imaging evaluation, the patient underwent ankle arthroscopy due to impingement of the joint, with limitation of mobility. Arthroscopic treatment allowed easy access to the joint, removal of loose bodies, and partial synovectomy, with low morbidity and early rehabilitation. The final prognosis was excellent.

RESUMO A condromatose sinovial é uma doença proliferativa, rara e caracterizada pela ocorrência de metaplasia na sinovial das articulações. Essas lesões tornam-se pediculadas e à medida que a doença evolui, as lesões se soltam, dão origem a corpos livres intra-articulares. A prevalência é maior em homens entre a terceira e quinta décadas de vida, atingindo normalmente grandes articulações como o joelho e o quadril. Articulações menores, como o tornozelo, são afetadas com menos frequência.Os pacientes referem dor articular, bloqueio e limitação da mobilidade causados pelos fragmentos livres. Com o evoluir da doença, a articulação sofre alterações degenerativas. Os autores apresentam um caso clínico de condromatose sinovial do tornozelo, tratado por artroscopia. O doente, do sexo masculino e de 59 anos, referia queixas de dor e edema do tornozelo esquerdo. Ao exame físico, apresentava limitação da mobilidade da tibiotársica (flexão plantar e dorsiflexão de 20° e 5°, respectivamente). Após avaliação clínica e estudo imagiológico, foi proposta artroscopia do tornozelo para tratamento de pinçamento articular com limitação da mobilidade. O tratamento artroscópico permitiu um fácil acesso à articulação, remoção dos corpos livres e sinovectomia parcial, com baixa morbilidade e reabilitação precoce. O prognóstico final foi excelente.

Bilateral symmetrical synovial chondromatosis of shoulder: a case report / Condromatose sinovial simétrica bilateral do ombro: relato de caso

ABSTRACT Synovial chondromatosis is a benign arthropathy rarely seen in diarthrodial joints. Extra-articular bilateral symmetrical synovial chondromatosis of shoulder is the rarest variety. The diagnosis is established with the help of imaging modalities and histopathological examinations. This report describes a case of a 39-year-old woman who presented with symmetrical, progressively increasing swelling over the bilateral shoulder region, of 12-18 months duration, with dull ache and restricted movements of the shoulder joints. Magnetic resonance imaging (MRI) and ultrasonography (USG) revealed large bilateral subacromial-subdeltoid bursal swelling with loose floating bodies. Surgical excision of extensive bilateral bursa was performed at four weeks of interval. Histopathological examination revealed synovial chondromatosis on either side. Postoperative recovery occurred without complications.

RESUMO A condromatose sinovial é uma artropatia benigna raramente vista em articulações diartrodiais. A condromatose sinovial simétrica bilateral extra-articular do ombro é a variedade mais rara. O diagnóstico é estabelecido com a ajuda de exames de imagem e histopatológicos. Este relato descreve o caso de uma paciente de 39 anos, com aumento de volume progressivo simétrico sobre a região bilateral do ombro com 12-18 meses de duração com dor entorpecido e limitação dos movimentos das articulações do ombro. A ressonância magnética e a ultrassonografia revelaram um grande aumento de volume da bursa subacromial subdeltoidea bilateral com corpos livres flutuantes. A excisão cirúrgica extensa da bursa bilateral foi feita com quatro semanas de intervalo. O exame histopatológico revelou condromatose sinovial em ambos os lados. A recuperação pós-operatória transcorreu sem complicações.

Synovial Osteochondromatosis of the Subtalar Joint in an Adolescent Baseball Player / 대한스포츠의학회지

Synovial chondromatosis is an uncommon disorder characterized by cartilaginous proliferation within the synovial membrane of the articular joint. Smaller joints are rarely affected and it may be progressed to osteochondromatosis after ossification or calcification of metaplastic cartilage. It is commonly presented in the third to fourth decade of life, but rarely presented in adolescence. We report a unique case of synovial osteochondromatosis of the subtalar joint in 14-year-old baseball player. Arthroscopic removal of loose body and complete excision of the osteochondral mass with concomitant synovectomy resulted in satisfactory outcome without recurrence at final follow-up.

Temporomandibular joint synovial chondromatosis accompanying temporal bone proliferation: A case report

Synovial chondromatosis is a rare metaplastic disease affecting the joints, including the temporomandibular joint (TMJ). Since its symptoms are similar to those of temporomandibular disorders, a careful differential diagnosis is essential. A 50-year-old male patient was referred with the chief complaint of pain and radiopaque masses around the left TMJ on panoramic radiography. Clinically, pre-auricular swelling and resting pain was found, without limitation of mouth opening. On cone-beam computed tomographic images, multiple calcified nodules adjacent to the TMJ and bone proliferation with sclerosis at the articular fossa and eminence were found. T2-weighted magnetic resonance images showed multiple signal-void nodules with high signal effusion in the superior joint space and thickened cortical bone at the articular fossa and eminence. The calcified nodules were removed by surgical excision, but the hypertrophic articular fossa and eminence remained. A histopathological examination confirmed the diagnosis. The patient was followed up few months later without recurrence.

Remaining Loose Bodies after Arthroscopic Surgery Including Extensive Capsulectomy for Synovial Chondromatosis of the Hip

BACKGROUND: The purpose of our study was to evaluate the usefulness of hip arthroscopy including extensive capsulectomy for synovial chondromatosis of the hip. METHODS: From 2008 to 2016, 13 patients with synovial chondromatosis of the hip were treated with arthroscopic removal of loose bodies and synovectomy using three arthroscopic portals. An extensive capsulectomy was performed to allow the remaining loose bodies to be out of the extracapsular space, and the excised capsule was not repaired. All patients were assessed by clinical scores and the radiographs were reviewed to determine whether the remaining loose bodies disappeared at the last follow-up. RESULTS: Eight men and two women were followed up for a minimum of 1 year (mean, 3.8 years; range, 1 to 6.8 years) after hip arthroscopy. Clinical outcomes such as modified Harris hip score, University of California Los Angeles score, and Western Ontario and McMaster Universities Osteoarthritis Index score improved at the last follow-up. Although seven hips had remaining loose bodies after arthroscopic surgery, the remaining loose bodies disappeared in five hips (71.4%) at the last follow-up. CONCLUSIONS: Arthroscopic surgery was useful to treat synovial chondromatosis of the hip. In spite of limited removal of loose bodies, arthroscopic procedures including extensive capsulectomy could be effective for the treatment of synovial chondromatosis of the hip.

Osteocondromatosis sinovial: a propósito de un caso / Synovial Osteo-chondromatosis: in Regards with a Case

La condromatosis sinovial es una lesión benigna, poco frecuente y de localización generalmente monoarticular de la membrana sinovial. Afecta a uno de cada 100.000 habitantes. Es 2 veces más frecuente en hombres, y daña fundamentalmente a grandes articulaciones: rodilla (70 %), cadera (20 %) y hombro (19 %). Los estudios imagenológicos son imprescindibles para poder realizar su diagnóstico. Se presenta el caso de un paciente de 20 años, que luego de realizar ejercicios físicos sistemáticos comenzó con aumento de volumen y limitación de movimientos a nivel del hombro izquierdo, acudió al ortopédico y se le impuso tratamiento luego de examen físico y de realizar estudios imagenológicos. Se presenta el caso porque constituye una entidad rara, en la que los estudios por imágenes juegan un rol importante para el diagnóstico y su ulterior tratamiento.

Synovial chondromatosis is a benign, infrequent lesion with a generally synovial membrane mono-articular location. It affects one in every 100,000 inhabitants. It is 2 times more frequent in men, and mainly affects large joints: knee (70 %), hip (20 %) and shoulder (19 %). Imaging studies are essential for diagnosis. A case of 20 year old patient is presented who after performing systematic physical exercises began with left shoulder volume increased and limited movement; he consulted the orthopedic and was prescribed treatment after physical examination and imaging studies. The case is presented because it is an infrequent medical entity in which imaging studies have a vital role for the diagnosis and posterior treatment.

Temporomandibular joint synovial chondromatosis extending to the temporal bone: a report of two cases

Synovial chondromatosis is a rare benign lesion originating from the synovial membrane. It presents as adhesive or non-adhesive intra-articular cartilaginous loose bodies. Although the causes of synovial chondromatosis have not been fully elucidated, inflammation, external injury, or excessive use of joints have been suggested as possible causes. Synovial chondromatosis has been reported to occur most frequently at large joints that bear weights, with a rare occurrence at the temporomandibular joint (TMJ). When synovial chondromatosis develops at TMJ, clinical symptoms, including pain, joint sounds, and mouth opening may common. Moreover, synovial chondromatosis rarely spreads to the mandibular condyle, glenoid cavity, or articular eminence of TMJ. The goal of this study was to discuss the methods of surgery and other possible considerations by reviewing cases of patients who underwent surgery for synovial chondromatosis that extended to the temporal bone.