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Imaging of Primary Synovial Osteochondromatosis: A Case Report

Synovial chondromatosis (primary or idiopathic) is characterised by the formation of multiple nodules of hyaline cartilage under the synovial membrane. These nodules may be released into the joint cavity and are typically numerous and of similar shape and size. They may agglomerate with each other and form masses that are sometimes large. Radiographically, isolated non-specific synovial swelling, multiple intra-articular calcifications or osteochondromes, extrinsic erosions of the bone opposite or reactive hyperostosis may be seen. The joint space is normal or enlarged, which is suggestive of the diagnosis (chondromal interposition/articular cartilage hypertrophy). The arthroscanner or, better still, the MRI, allows a precise assessment of the local extension. The semiology is influenced by the subsynovial or free nature of the chondromas, and by their degree of mineralisation and ossification. The treatment consists essentially of a synovectomy as complete as possible.