J Korean Orthop Assoc.  2008 Feb;43(1):131-134. 10.4055/jkoa.2008.43.1.131.

Synovial Chondromatosis of the Metacarpophalangeal Joint: A Case Report

• Kim JW
• Kweon SH
• Kim DC

• KMID: 2106429
• DOI: http://doi.org/10.4055/jkoa.2008.43.1.131

Abstract

Synovial chondromatosis is an uncommon lesion, which is characterized by cartilaginous and osseous metaplasia of the joint synovium. Synovial chondromatosis usually involves a large joint and rarely occurs in the hand. Intra-articular synovial chondromatosis during the hand should be considered in the differential diagnosis of swollen, stiff or painful joints. Other possible diagnoses include osteoarthritis, rheumatoid arthritis, gout, trauma and chronic infection. Moreover, if enchondral ossification of loose bodies is not seen a diagnosis of synovial chondromatosis can not be made preoperatively. Intra-articular synovial chondromatosis is a benign condition and surgical synovectomy remains the most effective treatment. The authors report a case of synovial chondromatosis of the fifth metacarpophalangeal joint.

Keyword

Fifth metacarpophalangeal joint; Synovial chondromatosis

MeSH Terms

Arthritis, Rheumatoid
Chondromatosis
Chondromatosis, Synovial
Diagnosis, Differential
Gout
Hand
Joints
Metaplasia
Osteoarthritis
Synovial Membrane

Figure

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  Fig. 1 Hand radiographs showing bony erosion of fifth metacarpal head and several calcifications of 1 to 2 millimeters in size.

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  Fig. 2 (A, B) T1-weighted MR images depicting an iso-intense intra-articular lesion (arrows). (C, D) T2-weighted MR images showing an intra-articular body of low signal intensity (arrowhead). The central area has the signal characteristics of hyaline cartilage.

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  Fig. 3 Intraoperative clinical photographs. (A) Approximately a 3×2 cm sized mass was exposed from the proximal third of the 5th metacarpal bone to the metacarpophalangeal joint. (B) Numerous chondrous nodules in the capsule wall were flowed out.

Reference

1. Constant E, Harebottle NH, Davis DG. Synovial chondromatosis of the hand. Plast Reconstr Surg. 1974. 54:353–358.

2. Crotty JM, Monu JU, Pope TL Jr. Synovial osteochondromatosis. Radiol Clin North Am. 1996. 34:327–342.

3. Hettiaratchy SP, Nanchahal J. Synovial chondromatosis of the metacarpophalang eal Joint. J Hand Surg Br. 2002. 27:104–106.

4. Maurice H, Crone M, Watt I. Synovial chondromatosis. J Bone Joint Surg Br. 1988. 70:807–811.

5. Milgram JW. Synovial osteochondromatosis: a histopathological study of thirty cases. J Bone Joint Surg Am. 1977. 59:792–801.

6. Murphy FP, Dahlin DC, Sullivan CR. Articular synovial chondromatosis. J Bone Joint Surg. 1962. 44:77–86.

7. Kramer J, Recht M, Deely DM, et al. MR appearance of idiopathic synovial osteochondromatosis. J Comput Assist Tomogrt. 1993. 17:772–776.

8. Reed SC, Wright CS. Synovial chondromatosis of the metacarpophalangeal joint: case report and review of the literature. Can J Surg. 1996. 39:407–409.