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Synovial Chondromatosis: A Rare Differential Diagnosis of Hip Pain in a Child.

ABSTRACT: Primary synovial chondromatosis (SC) is a disease of the synovium occurring in the third to fifth decade of life with the peak incidence in the fifth decade and commonly involves the knee in 50% cases. The diagnosis of SC is primarily radiological and intraoperative. Primary SC of the hip is rare, and their prevalence is not known.A 7-year-old female child presented with pain and limp left hip for 6 weeks. She had a stiff hip gait. Clinical examination revealed a fixed abduction, flexion deformity, and restricted internal rotation with apparent lengthening of 2 cm. The ultrasonography revealed synovial effusion with synovial deposits. Magnetic resonance imaging revealed features of tuberculous synovitis, inflammatory synovitis, or a rare possibility of SC. Arthrotomy was performed following failed hip aspiration. Multiple chondral loose bodies were noted on incision of capsule. Partial synovectomy was also performed. The synovium histopathology revealed multiple synovial chondral inclusions. A final diagnosis of SC was made.We report this case of primary SC, 7-year-old female patient with symptoms of hip pain, limp, and fixed deformities restricting hip function as a first of its kind in the mentioned age group. Hence, although rare SC may be considered as one of the differential diagnosis in hip symptoms in children <10 years of age.

SUBMITTER: Philip MC

PROVIDER: S-EPMC5553833 | biostudies-other | 2017 Mar-Apr

REPOSITORIES: biostudies-other

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Temporomandibular joint synovial chondromatosis: An analysis of 7 cases and literature review.

Project description:ObjectiveTo investigate the diagnosis and treatment procedure of synovial chondromatosis (SC) of the temporomandibular joint (TMJ).MethodsClinical features, imaging features, surgical methods, and prognosis of 7 patients with SC of the TMJ were analyzed. We also reviewed and analyzed surgery-relevant literature included in the Pubmed database in the past decade using the search terms "synovial chondromatosis" and "temporomandibular joint", and found 181 cases.ResultsThere was no specific difference in the symptoms of SC in the TMJ in different Milgram's stages in our cases and the cases mentioned in the literature. The main symptoms of SC in the TMJ were pain (100%, 7/7; 64.64%, 117/181), limited mouth opening (57.14%, 4/7; 53.59%, 97/181), swelling (14.29%, 1/7; 28.18%, 51/181), crepitus (28.57%, 2/7; 19.34%, 35/181), and clicking (14.29%, 1/7; 9.94%, 18/181) in our cases and cases from literature separately. The imaging features of SC were occupying lesions (including loose bodies or masses) (71.42%, 5/7; 37.57%, 68/181), bone change in condyle or glenoid fossa (1/7, 14.29%; 34.81%, 63/181), effusion (42.86%, 3/7; 20.99%, 38/181), joint space changes (42.86%, 3/7; 11.05%, 20/181) in our cases and cases from literature separately. The surgical procedures seem to depend mainly on the involved structures and the extension of the lesion rather than the Milgram's stage.ConclusionsThe clinical features of SC in the TMJ are nonspecific and easy to be misdiagnosed. MRI is helpful in the diagnosis of SC in the TMJ. The surgical procedures mainly depend on the involved structures and the extension of the lesion.

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