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Primary synovial osteochondromatosis of the hand and wrist. Report of a series of 21 cases and literature review.

OBJECTIVES
To define the characteristics of synovial osteochondromatosis of the hand and wrist.


PATIENTS AND METHODS
Retrospective study of 21 patients, including 11 with intraarticular and 10 with tenosynovial disease. Cases secondary to degenerative joint disease were excluded. Surgery consisted in removal of the osteocartilaginous bodies and of the adjacent synovial membrane. Mean follow-up was seven years (range, three to 18 years). The relevant literature was reviewed in part.


RESULTS
Recurrence was seen in four patients and was multiple in two of these four. Most recurrences occurred within five to ten years after surgery. All four patients with recurrences had intraarticular disease. No cases of malignant transformation were seen. The characteristics of synovial osteochondromatosis at the hand and wrist are reviewed.


CONCLUSION
Detailed preoperative investigations including computed arthrotomography and magnetic resonance imaging should be performed to increase the likelihood of complete excision.