We report a case of a 49 year old prison guard with synovial chondromatosis affecting the ... Other affected joints include the elbow, shoulder and ankle joints.
A Case of Elbow Synovial Chondromatosis Alvin Mallia, Neil Ashwood
Trauma and Orthopaedics Department, Queens Hospital & Burton Hospital NHS Foundation Trust, Burton-on-Trent, UK
Case Presentation We report a case of a 49 year old prison guard with synovial chondromatosis affecting the right elbow joint. Clinical examination revealed a significant swelling of the affected joint with a reduced range of movement of 40- 120 degrees. Simple radiographs revealed calcified bodies within the joint space. He underwent arthroscopic removal of the loose bodies. Post operative evaluation at 6 months showed a marked reduction in joint swelling with significant improvement in the range of motion. There was also a change in the overall functionality of the joint, and the patient returned to playing golf without discomfort.
Synovial Chondromatosis Synovial chondromatosis is a condition in which mesenchymal remnants of synovial tissue undergo metaplasia leading to the formation of cartilaginous nodules within the synovium (1). In advanced cases loose bodies form and occupy the synovial space resulting in joint discomfort, stiffness and a gritty or locking sensation. Synovial chondromatosis typically presents as a monoarticular condition, with the knee being the most commonly affected joint. Other affected joints include the elbow, shoulder and ankle joints. Very few cases of synovial osteochondromatosis of the elbow have been reported in the literature, with the first report in 1918 by Henderson (2). The male to female ratio is 2:1, and it often affects patients aged 20 to 40. Changes in the joint can be see on radiographs, CT or MRI scans, with a definitive diagnosis being made histologically. Treatment consists of arthroscopic removal of loose bodies and of a partial or full synovectomy. Total synovectomy can lead to clonally significant stiffness after surgery, with reported rates of up to 43% when the procedure is performed by means of open arthrotomy. There have been reported low recurrence rates after arthroscopic treatment and no postoperative stiffness with simple excision of loose bodies (3). References 1. Narasimhan Rishi, Kennedy Stuart, Tewari Sandeep. Synovial chondromatosis of the elbow in a child 2. Giannetti S1, Santucci A, Patricola A, Neglected synovial osteochondromatosis of the elbow: a rare case. 3. Kirchhoff C, Buhmann S, Braunstein V, Synovial chondromatosis of the long biceps tendon sheath in a child: a case report and review of the literature
