Synovial chondromatosis of the shoulder: A rare case report

Abstract

Synovial chondromatosis is a monarticular svnovial proliferative disease in which cartilaginous or osteocartilaginous metaplasia occurs within the synovial membrane of joints, bursae or tendon sheaths. The disease has been classified into three phases. 1: Early: with svnovial chondrometaplasia but no loose bodies; 2: Transitional: with active svynovial disease and loose bodies; 3: Late: With loose bodies but no synovial disease.Cartilaginous metaplasia from joint, tendo, or bursal synovial lining differentiates this entity from loose bodies arising from degenerative arthritis, osteochondritis dissecans. and osteochondral fractures. A 54 Year Hindu male presented to the orthopaedic OPD with complains of pain and swelling in left shoulder which was insidous in onset, gradually progressive in nature and not relieved by medications. Patient also complained of clicking noise during shoulder movements which was insidous in onset and gradually progressive in nature. Synovial chondromatosis is a synovial lesion seen generally in adults with a male predominance. It occurs most commonly in the knee, unsually also occuring at the hand, wrist, elbow and shoulder. It can lead to mechanical symptoms, decreased range of motion and effusion. Histopath shows nodules of moderately cellular hyaline cartilage. D/D can include Myositis Ossificans, Synovial Chondrosarcoma and Synoval Sarcoma. Treatment is usually observation if asymptomatic. It symptomatic, then arthroscopic or open synovectomy can be done, arthroscopy increases chances of recurrence.