What Is Synovial Osteochondromatosis?

Primary synovial osteochondroma disease (Synovial Chondromatosis), also known as Synovial Chondrometaplasia, is a rare benign joint disease, is a joint disease caused by synovial cartilage metaplasia.

Synovial chondroma

Primary synovial osteochondroma disease (Synovial Chondromatosis), also known as Synovial Chondrometaplasia, is a rare benign joint disease, is a joint disease caused by synovial cartilage metaplasia.
Western Medicine Name
Synovial chondroma
English name
Synovial Chondromatosis
Disease site
Arthropathy
Also known as
Synovial cartilage metaplasia
Reichel first reported it in 1900 for unknown reasons. It is characterized by the formation of cartilage nodules on the synovium. These cartilage bodies are mostly grit-shaped and can reach dozens of times. They can grow pedicled, protrude into the joint cavity, or fall off into the joint cavity and become free bodies ( Articular rats), which are nourished by joint synovial fluid and gradually grow up. Later stage cartilage nodules can be calcified or ossified, so it is also called synovial osteochondromatosis. The disease is prevalent in the joints, especially in the knee, hip, elbow, and shoulder joints. Occasionally, the metacarpophalangeal and interphalangeal joint bursa and tendon sheath occur unilaterally.
Intra-articular free bodies (also known as joint mice) are caused by joint trauma or some special lesions that cause the cartilage, bone and other tissue fragments to fall off and remain in the joint. Because the free body can change its position in the joint cavity due to the movement of the joint, it moves like a mouse in the joint, so the free body in the joint is also called an articular rat. Joint mice occur most often in the knee joint. Common causes are exfoliative osteochondritis, synovial osteochondromatosis, osteoarthritis, osteochondral surface fractures, and intra-articular hematomas or infections. Most patients had a history of knee trauma or joint disease. This disease is more common in young people, more men than women, mostly unilateral.
1. Pain in the knee joint, which can worsen during exercise, and can sometimes make the patient fall. Repeatedly, the knee joint suddenly locks and cannot be straightened and flexed. After a slight movement of the knee joint, a popping sound often occurs, and then the symptoms disappear. After the attack, the joints can swell and effusion.
2. The pain site is often different at each attack. Patients can often find the joint mouse that is hidden from time to time. It can be a single or several.
3. Sometimes the joint mouse can be touched in the shallow surface of the knee joint. Knee movements can be restricted. Quadriceps atrophy can occur.
4. Elderly patients may develop osteoarthritis.
1. Joint cavity effusion, no echo area appears in the joint cavity, the joint cavity is enlarged, the synovial membrane is thickened and uneven, and the echo is enhanced.
2. When the synovium of the joint capsule swells to the spotted strong echogenic nodule, it forms a joint free body. The number can be only one or several, ranging in size, with a maximum diameter of several centimeters, and the free body is round, oval, and mulberry-shaped, and moves with joint movement.
3. Sometimes the articular surface is not smooth, the echo of articular cartilage is enhanced or the defect is broken.
4. In the knee joint, supracondylar bursitis and popliteal cyst often occur at the same time.
Macroscopic view of pathology, synovial membrane is limited or extensively involved, tumors vary in size and number, are grayish-white translucent bodies, and range in diameter from 1mm-3mm. A single large nodule is also called a giant solitary synovial chondroma, which is also seen. The articular surface of the primary synovial chondromatosis is normal, and the articular surface of the secondary is often degenerative. Histologically, the tumor can be calcified or ossified; cartilage nodules appear in the synovium, the arrangement is not regular, the number of chondrocytes is large, the volume is large, the pleomorphic nucleus is large, and the cells are heterotypic However, the disease is a benign, non-invasive disease.
Milgraml divides synovial osteochondromatosis into three stages: stage I is active (chondrogenesis, no corpuscles); stage II is transitional (metaplasia, with corpuscles); stage III is stationary (with corpuscles) Body without metaplasia).
Occasionally, synovial chondroma malignancy becomes chondrosarcoma.
Synovial chondroma pathological section
Intra-articular free body postoperative specimen

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