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Synovial Chondromatosis
Derik L. Davis, MD; B. J. Manaster, MD, PhD, FACR
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        TERMINOLOGY

        • Abbreviations

          • Synovial chondromatosis (SC)
        • Synonyms

          • Primary SC; synovial osteochondromatosis (not recommended)
            • Neither term favored
            • WHO no longer advocates primary and secondary SC, since SC is considered neoplasm, and intraarticular osteochondral bodies in osteoarthritis are not
        • Definitions

          • Benign neoplastic process
            • Located in synovium-lined spaces: joint, bursa, tendon sheath
            • Proliferation of hyaline cartilaginous bodies ± internal mineralization

        IMAGING

        • General Features

          • Imaging Recommendations

            • Radiographic Findings

              • CT Findings

                • MR Findings

                  DIFFERENTIAL DIAGNOSIS

                    PATHOLOGY

                    • General Features

                      • Gross Pathologic & Surgical Features

                        • Microscopic Features

                          CLINICAL ISSUES

                          • Presentation

                            • Demographics

                              • Natural History & Prognosis

                                • Treatment

                                  DIAGNOSTIC CHECKLIST

                                  • Image Interpretation Pearls

                                    Selected References

                                    1. Ashir A et al: Intraligamentous synovial chondromatosis of the anterior cruciate ligament. Skeletal Radiol. 49(4):645-50, 2020
                                    2. Kwee RM et al: Calcified or ossified benign soft tissue lesions that may simulate malignancy. Skeletal Radiol. 48(12):1875-90, 2019
                                    3. de Sa D et al: Arthroscopic surgery for synovial chondromatosis of the hip: a systematic review of rates and predisposing factors for recurrence. Arthroscopy. ;30(11):1499-504, 2014
                                    4. Evans S et al: Synovial chondrosarcoma arising in synovial chondromatosis. Sarcoma. 2014:647939, 2014
                                    5. Yao MS et al: Synovial chondrosarcoma arising from synovial chondromatosis of the knee. JBR-BTR. 95(6):360-2, 2012
                                    6. Nakanishi S et al: Bone morphogenetic proteins are involved in the pathobiology of synovial chondromatosis. Biochem Biophys Res Commun. 379(4):914-9, 2009
                                    7. Zamora EE et al: Synovial chondrosarcoma: report of two cases and literature review. Eur J Radiol. 72(1):38-43, 2009
                                    8. Bui-Mansfield LT et al: Magnetic resonance appearance of intra-articular synovial sarcoma: case reports and review of the literature. J Comput Assist Tomogr. 32(4):640-4, 2008
                                    9. Chong CC et al: Radiotherapy in the management of recurrent synovial chondromatosis. Australas Radiol. 51(1):95-8, 2007
                                    10. Murphey MD et al: Imaging of synovial chondromatosis with radiologic-pathologic correlation. Radiographics. 27(5):1465-88, 2007
                                    11. Crawford A et al: A case of chondromatosis indicates a synovial stem cell aetiology. Rheumatology (Oxford). 45(12):1529-33, 2006
                                    12. Jbara M et al: MR imaging: Arthropathies and infectious conditions of the elbow, wrist, and hand. Radiol Clin North Am. 44(4):625-42, ix, 2006
                                    13. Lim SJ et al: Operative treatment of primary synovial osteochondromatosis of the hip. J Bone Joint Surg Am. 88(11):2456-64, 2006
                                    14. Butt SH et al: Primary synovial osteochondromatosis presenting as constrictive capsulitis. Skeletal Radiol. 34(11):707-13, 2005
                                    15. Chillemi C et al: Primary synovial chondromatosis of the shoulder: clinical, arthroscopic and histopathological aspects. Knee Surg Sports Traumatol Arthrosc. 13(6):483-8, 2005
                                    16. Hopyan S et al: Dysregulation of hedgehog signalling predisposes to synovial chondromatosis. J Pathol. 206(2):143-50, 2005
                                    17. Ryan RS et al: Synovial osteochondromatosis: the spectrum of imaging findings. Australas Radiol. 49(2):95-100, 2005
                                    18. Sheldon PJ et al: Imaging of intraarticular masses. Radiographics. 25(1):105-19, 2005
                                    19. Chan WL et al: Tenosynovial osteochondromatosis of both flexor and extensor tendons. Hand Surg. 9(1):89-95, 2004
                                    20. Robinson P et al: Primary synovial osteochondromatosis of the hip: extracapsular patterns of spread. Skeletal Radiol. 33(4):210-5, 2004
                                    21. Buddingh EP et al: Chromosome 6 abnormalities are recurrent in synovial chondromatosis. Cancer Genet Cytogenet. 140(1):18-22, 2003
                                    22. Fetsch JF et al: Tenosynovial (extraarticular) chondromatosis: an analysis of 37 cases of an underrecognized clinicopathologic entity with a strong predilection for the hands and feet and a high local recurrence rate. Am J Surg Pathol. 27(9):1260-8, 2003
                                    23. Wittkop B et al: Primary synovial chondromatosis and synovial chondrosarcoma: a pictorial review. Eur Radiol. 12(8):2112-9, 2002
                                    Related Anatomy
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                                    Related Differential Diagnoses
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                                    References
                                    Tables

                                    Tables

                                    KEY FACTS

                                    • Terminology

                                      • Imaging

                                        • Top Differential Diagnoses

                                          TERMINOLOGY

                                          • Abbreviations

                                            • Synovial chondromatosis (SC)
                                          • Synonyms

                                            • Primary SC; synovial osteochondromatosis (not recommended)
                                              • Neither term favored
                                              • WHO no longer advocates primary and secondary SC, since SC is considered neoplasm, and intraarticular osteochondral bodies in osteoarthritis are not
                                          • Definitions

                                            • Benign neoplastic process
                                              • Located in synovium-lined spaces: joint, bursa, tendon sheath
                                              • Proliferation of hyaline cartilaginous bodies ± internal mineralization

                                          IMAGING

                                          • General Features

                                            • Imaging Recommendations

                                              • Radiographic Findings

                                                • CT Findings

                                                  • MR Findings

                                                    DIFFERENTIAL DIAGNOSIS

                                                      PATHOLOGY

                                                      • General Features

                                                        • Gross Pathologic & Surgical Features

                                                          • Microscopic Features

                                                            CLINICAL ISSUES

                                                            • Presentation

                                                              • Demographics

                                                                • Natural History & Prognosis

                                                                  • Treatment

                                                                    DIAGNOSTIC CHECKLIST

                                                                    • Image Interpretation Pearls

                                                                      Selected References

                                                                      1. Ashir A et al: Intraligamentous synovial chondromatosis of the anterior cruciate ligament. Skeletal Radiol. 49(4):645-50, 2020
                                                                      2. Kwee RM et al: Calcified or ossified benign soft tissue lesions that may simulate malignancy. Skeletal Radiol. 48(12):1875-90, 2019
                                                                      3. de Sa D et al: Arthroscopic surgery for synovial chondromatosis of the hip: a systematic review of rates and predisposing factors for recurrence. Arthroscopy. ;30(11):1499-504, 2014
                                                                      4. Evans S et al: Synovial chondrosarcoma arising in synovial chondromatosis. Sarcoma. 2014:647939, 2014
                                                                      5. Yao MS et al: Synovial chondrosarcoma arising from synovial chondromatosis of the knee. JBR-BTR. 95(6):360-2, 2012
                                                                      6. Nakanishi S et al: Bone morphogenetic proteins are involved in the pathobiology of synovial chondromatosis. Biochem Biophys Res Commun. 379(4):914-9, 2009
                                                                      7. Zamora EE et al: Synovial chondrosarcoma: report of two cases and literature review. Eur J Radiol. 72(1):38-43, 2009
                                                                      8. Bui-Mansfield LT et al: Magnetic resonance appearance of intra-articular synovial sarcoma: case reports and review of the literature. J Comput Assist Tomogr. 32(4):640-4, 2008
                                                                      9. Chong CC et al: Radiotherapy in the management of recurrent synovial chondromatosis. Australas Radiol. 51(1):95-8, 2007
                                                                      10. Murphey MD et al: Imaging of synovial chondromatosis with radiologic-pathologic correlation. Radiographics. 27(5):1465-88, 2007
                                                                      11. Crawford A et al: A case of chondromatosis indicates a synovial stem cell aetiology. Rheumatology (Oxford). 45(12):1529-33, 2006
                                                                      12. Jbara M et al: MR imaging: Arthropathies and infectious conditions of the elbow, wrist, and hand. Radiol Clin North Am. 44(4):625-42, ix, 2006
                                                                      13. Lim SJ et al: Operative treatment of primary synovial osteochondromatosis of the hip. J Bone Joint Surg Am. 88(11):2456-64, 2006
                                                                      14. Butt SH et al: Primary synovial osteochondromatosis presenting as constrictive capsulitis. Skeletal Radiol. 34(11):707-13, 2005
                                                                      15. Chillemi C et al: Primary synovial chondromatosis of the shoulder: clinical, arthroscopic and histopathological aspects. Knee Surg Sports Traumatol Arthrosc. 13(6):483-8, 2005
                                                                      16. Hopyan S et al: Dysregulation of hedgehog signalling predisposes to synovial chondromatosis. J Pathol. 206(2):143-50, 2005
                                                                      17. Ryan RS et al: Synovial osteochondromatosis: the spectrum of imaging findings. Australas Radiol. 49(2):95-100, 2005
                                                                      18. Sheldon PJ et al: Imaging of intraarticular masses. Radiographics. 25(1):105-19, 2005
                                                                      19. Chan WL et al: Tenosynovial osteochondromatosis of both flexor and extensor tendons. Hand Surg. 9(1):89-95, 2004
                                                                      20. Robinson P et al: Primary synovial osteochondromatosis of the hip: extracapsular patterns of spread. Skeletal Radiol. 33(4):210-5, 2004
                                                                      21. Buddingh EP et al: Chromosome 6 abnormalities are recurrent in synovial chondromatosis. Cancer Genet Cytogenet. 140(1):18-22, 2003
                                                                      22. Fetsch JF et al: Tenosynovial (extraarticular) chondromatosis: an analysis of 37 cases of an underrecognized clinicopathologic entity with a strong predilection for the hands and feet and a high local recurrence rate. Am J Surg Pathol. 27(9):1260-8, 2003
                                                                      23. Wittkop B et al: Primary synovial chondromatosis and synovial chondrosarcoma: a pictorial review. Eur Radiol. 12(8):2112-9, 2002