ORTHOPAEDICS


Case 6 : (x-ray)

59 years old female with presenting symptoms of osteoarthritis knee. On Examination - fixed mass on superior and lateral aspect of patella.
Xrays done....What is the diagnosis?

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Peroperative - well encapsulated multiple chondromas fixed by soft tissue at one place to bone
just lateral to patella.

Answer:

Synovial chondromatosis


Discussion:

This is regarded as a benign neoplasm, in which metaplastic cartilage formation occurs throughout the synovium. Young and middle-aged adults are affected, with a male preponderance, and commonly involvement of the knee joint.

Cartilaginous lesions develop throughout the synovium and later become pedunculated, separating into the joint space. When large enough, they undergo ossification. This condition progresses in phases, with episodes of intra-synovial disease and shedding of loose bodies.

Plain films reveal numerous oval/ round opacities, of similar size, seen around the joint. Scintigraphy often demonstrates an appreciable increase in activity localized particularly in the larger masses, suggesting that active ossification and calcification are occurring.

Synovial chondromatosis may also occur in tendon sheaths and bursae. Chondrosarcoma is a rare occurrence.


Contribution:

Dr. Vinod Naneria, Orthopedic Surgeon, Choitram Hospital, Indore.

vnaneria@vsnl.com

 


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