Chondromatosis

Idiopathic synovial chondromatosis involves the joints, with or without involvement of adjacent bursae. Metaplastic formation of cartilage from subsynovial connective tissue leads to cartilage nodules that may calcify or ossify. Almost always only a single joint is affected, and a chronic progressive course is followed. The joints affected most commonly are the knee, hip, glenohumeral joint, and elbow. Joint pain, limitation of motion, and intra-articular formation of osteocartilaginous bodies is common. Rarely the disease may become malignant.

On radiographs, multiple intra-articular radiodense shadows are often noted, which show varying degrees of mineralization (chondrification or ossification). Erosions of the adjacent bone and widening of the joint space may also occur. Arthrography may be required for visualization of noncalcified lesions. Late in the course of the disease, secondary osteoarthritis is commonly present and patients show joint space narrowing with eburnation and osteophyte formation.

Extra-articular synovial chondromatosis or tenosynovial chondromatosis arises in close association with a tendon, tendon sheath or joint capsule, usually in the hand, wrist, or foot. Characteristically the patient exhibits a slowly enlarging mass containing multiple calcified or ossified dense shadows.

DR