Wrist Synovial Chondromatosis: Case Report and Literature Review

Abstract

Primary synovial chondromatosis is a proliferation of cartilaginous bodies within the synovial membrane, tendon sheath or bursa. It is a rare orthopaedic entity especially when it occurs in the distal radioulnar joint. We report a 27-year-old man with recurrent synovial chondromatosis, nine years after his first operation. Although rare, synovial chondromatosis must be considered in the differential diagnosis in a patient with pain and swelling of the distal radioulnar joint. From our literature review, we report a 17% (5/30) recurrence rate for synovial chondromatosis involving the wrist joint which has not been documented in the medical literature previously.

Management of Synovial Osteochondromatosis of the Distal Radioulnar Joint with Imaging Features Consistent with Malignancy

“…There have been fewer than 15 previous reports of synovial osteochondromatosis of the distal radioulnar joint [4]. Herein, we report an additional case which presented with radiographic features worrisome for a soft tissue sarcoma.…”

“…It is most common in the larger joints such as the knee, hip, shoulder, and elbow and is relatively uncommon in the hand and wrist. Synovial osteochondromatosis of the distal radioulnar joint is most commonly found in males in the 2nd through 4th decades of life [4]. Prior injury of the wrist does not appear to increase the likelihood of developing this condition in the distal radioulnar joint [3].…”

“…The current standard for the treatment of synovial osteochondromatosis involves the removal of any nodules and loose bodies from the synovial cavity and excision of diseased synovium [4, 10]. Postoperative recurrence has been reported at 17% for synovial osteochondromatosis of the wrist, and patients tend to do well clinically following excision of the mass [4].…”

“…Postoperative recurrence has been reported at 17% for synovial osteochondromatosis of the wrist, and patients tend to do well clinically following excision of the mass [4]. In cases of recurrence, additional surgery is usually indicated.…”

Extra-articular chondromatosis of flexor and extensor compartments of the hand: Case report and review of literature

“…1 It is possible to define a primary form, of unknown etiology, and a secondary form linked to joint diseases such as osteoarthritis, osteochondral fractures and neuropathic arthropathy. As regards joint localization, we are able to identify an intra-articular form, which is the most common (incidence of 1:100,000) 2 , 3 and an extra-articular form. 2 , 4 – 6 …”