Objective:
To study the clinical manifestations, use of diagnostic imaging techniques and outcome of patients with synovial chondromatosis in our health area.
Patients and methods:
Povisa hospital provides health services to a population of 127,000 inhabitants. the clinical histories of all the patients in this area who were histologically diagnosed with synovial chondromatosis between january 1992 and december 2003 were reviewed.
Results:
There were 38 cases of joint chondromatosis, all monoarticular, and one case of extra-articular chondromatosis in 20 men and 19 women aged 56.5±12.7 years (mean±sd) at diagnosis (range: 16-79 years). the main joint affected was the knee (15; 39.5%), followed by the hip (8; 21%) and the temporomandibular joint and elbow, both of these in three patients (7.9%). previous arthropathy was recorded in 18 patients (18/38, 47.4%). symptom duration prior to diagnosis was 25.4±34 months. the most frequent clinical manifestations were joint pain (100%), restricted movement (77%) and swelling (57%). plain radiographs were carried out in all patients and suggested the diagnosis in 20 (51.3%). magnetic resonance imaging findings led to a diagnosis in 12 out of 15 patients in whom this procedure was required (80%). in all patients loose bodies were removed and synovectomy was performed by arthroscopic procedures in six. in 16 patients (42%) total joint replacement was required. the mean postoperative follow-up was 23.7±5.3 months. no cases of chondrosarcoma were identified and the recurrence rate was low (7.9%).
Conclusions:
In our setting, almost half (47.4%) of the cases of synovial chondromatosis occurred in a previously damaged joint: the correct diagnosis was delayed by more than 2 years and total arthroplasty was required in 42% of the patients.