Connective Tissue Disorders UpdateMedlinePlus sent this bulletin at 10/05/2012 01:14 PM EDT New on the MedlinePlus Connective Tissue Disorders page:
10/03/2012 08:00 PM EDT
Source: American Academy of Orthopaedic Surgeons
Synovial chondromatosis (also called synovial osteochondromatosis) is a rare, benign condition that involves the synovium, which is the thin layer of tissue that lines joints.
Although this type of tumor does not spread to other parts of the body, it can cause severe damage to the joint and lead to osteoarthritis. Early treatment is important to relieve painful symptoms and prevent further damage.
The loose cartilage bodies in the joint may vary in size from a few millimeters (such as the size of a small pill) to a few centimeters (the size of a quarter). The synovial fluid nourishes the loose bodies and they may grow, calcify, or ossify (turn into bone). They can then roll around like loose marbles and damage the articular cartilage, causing osteoarthritis. In osteoarthritis, damaged cartilage becomes worn and frayed. Moving the bones along this exposed surface is painful.
In this x-ray of an ankle, the calcified loose bodies are clearly visible (arrows).
In severe cases, the loose bodies may grow large enough to occupy the entire joint space or penetrate into adjacent tissues. Synovial chondromatosis most often occurs in the knee, followed by the hip, elbow, and shoulder. In most cases, only one joint in the body is affected.
Most cases of synovial chondromatosis occur in middle-aged people between the ages of 30 and 50. Men are affected twice as often as women.
Medical History and Physical ExaminationAfter discussing your symptoms and medical history, your doctor will examine your painful joint. He or she will ask you to move it in various positions to see if there is pain or restricted motion. Your doctor will also look for creaking or grinding noises (crepitus) that indicate bone-on-bone friction.
Diagnostic imaging tests provide your doctor with pictures of your bones, muscles, nerves, cartilage, and organs. Imaging tests may help your doctor differentiate synovial chondromatosis from osteoarthritis.X-rays.This test provides good images of dense structures, like bone. If the loose bodies are not calcified, however, they may not show up in an x-ray.
Other imaging tests. Loose bodies typically show up very well on magnetic resonance imaging (MRI), which creates better images of soft tissue. Computed tomography (CT) also provides your doctor with a more detailed picture than an x-ray, and loose bodies can usually be seen in these scans.
In addition to the loose bodies, imaging tests can show your doctor additional problems, such as fluid in the joint and signs of osteoarthritis (narrowing of the joint space and bone spurs).
(Left) In this x-ray of the knee joint, calcified loose bodies are barely visible (yellow arrows). (Right) This MRI shows a cross-section image of the same knee. The loose bodies show up clearly.
A traditional, open surgical procedure involves a single large incision. In arthroscopy, small incisions and miniature surgical tools are used to remove the loose bodies.
The end results of traditional and arthroscopic procedures are the same. Your doctor will discuss the surgical procedure that best meets your needs.
Although not common, synovial chondromatosis can return. For a period of time after surgery, your doctor will schedule regular, follow-up visits to check for any recurrence. He or she will also monitor any progression of osteoarthritis. The amount of damage synovial chondromatosis has already done to the joint will influence the chance of arthritis developing.
Last reviewed: May 2011
AAOS does not endorse any treatments, procedures, products, or physicians referenced herein. This information is provided as an educational service and is not intended to serve as medical advice. Anyone seeking specific orthopaedic advice or assistance should consult his or her orthopaedic surgeon, or locate one in your area through the AAOS "Find an Orthopaedist" program on this website.