A rare case of synovial chondromatosis of distal radio-ulnar joint

Int J Surg Case Rep. 2022 Jun:95:107149. doi: 10.1016/j.ijscr.2022.107149. Epub 2022 May 4.

Abstract

Introduction: Synovial chondromatosis (SC) is a benign metaplastic proliferation of cartilaginous nodules within the synovial membrane that commonly manifests as "loose masses" in the joint space. Synovial chondromatosis affects 1.8 per 1 million individuals. The most common articulations affected are the knees, followed by the hip, elbows, and shoulder. The wrist, on the other hand, is rarely affected. Synovial chondromatosis occurs mostly in the third or fifth decade of life.

Presentation of case: A 30-year-old Saudi, non-married female patient presented to the outpatient orthopaedic clinic complaining of right wrist pain for 5 years. The pain started gradually with on and off pain episodes. Her magnetic resonance imagining was ordered which showed large radio ulnar joint effusion associated with synovitis with multiple low- intensity foci corresponding to subtle calcifications which are all consistent with synovial chondromatosis which was successfully treated with surgery. Eventually, the patient reported that her quality of life was hugely improved especially in terms of pain, stiffness, and range of motion.

Conclusion: Synovial chondromatosis in radio-ulnar joint is a very rare entity. Surgical exploration of the joint, removal of loose bodies alone or combined with synovectomy, is the recommended treatment.

Keywords: Chondromatosis; Joint; Radio-ulnar; Surgery; Synovial.