Asymptomatic Synovial Chondromatosis of the Ankle: An Incidental Finding

doi:10.1053/j.jfas.2010.08.002

The Journal of Foot and Ankle Surgery

Volume 49, Issue 6, November–December 2010, Pages 565.e13-565.e17

https://doi.org/10.1053/j.jfas.2010.08.002 Get rights and content

Abstract

Synovial chondromatosis is an uncommon, benign lesion of nodular cartilaginous neoplastic development of the synovium that can lead to loose bodies and arthritic degeneration if left untreated. Although very rare, malignant transformation to chondrosarcoma can occur. Primary and secondary forms of synovial chondromatosis also exist, and each has distinct clinical, radiographic, and histologic characteristics. In this article, we describe a case of extensive primary synovial chondromatosis of the ankle that was asymptomatic until just before presentation, and that was treated by means of open synovectomy with excision of the osteochondromatous lesions within the joint.

Section snippets

Case Report

A 58-year-old-female presented with a chief complaint of the sudden onset of pain localized to the posterior aspect of her right heel, aggravated by standing and walking. There was no history of recent trauma. She wore over-the-counter shoe inserts, and occasional warm soaks with Epsom salts had been performed with only minimal relief. Her past medical history included uterine carcinoma that was in remission, sarcoidosis with ocular manifestations, no current active lung disease (although

Discussion

Although the exact mechanism remains unclear, synovial chondromatosis is thought to evolve from spontaneous undifferentiated stem-cell proliferation in the stratum synoviale. It is thought that mesenchymal cells at the synovium-articular cartilage junction proliferate, forming nodular foci of hyaline cartilage that often detach and remain as loose bodies within the synovial folds and articular cavity, and the nodules may calcify and even ossify over time 1, 3, 4, 5, 7, 10. In addition to

Acknowledgments

Daniel Evans, DPM, Department of Radiology, Scholl College of Podiatric Medicine, North Chicago, IL, for interpretation of radiographic features associated with this case.

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There are more references available in the full text version of this article.

Cited by (9)

Isolated synovial chondromatosis of the ankle: A case report
2023, International Journal of Surgery Case Reports
At the age of 20, young adults are most susceptible to synovial chondromatosis, a rare condition characterized by the metaplasia of the synovial membrane into cartilaginous or osteocartilaginous tissue. Synovial chondromatosis is exceptionally uncommon in the ankle.
An orthopedist evaluated a 26-year-old man with a history of recurring ankle trauma over a period of 6 months, swelling and pain. An ankle radiograph revealed calcified foreign bodies, while arthrography displayed enlarged oval bodies with contrasting features and intra-articular effusion encapsulated heterogeneously. Subsequent arthroscopy, following contrast injection, revealed intra-articular contrast effusion. During the arthroscopic procedure, multiple osteochondromas were discovered. A synovectomy was performed, and pathological analysis confirmed the presence of synovial chondromatosis.
Synovial chondromatosis of the ankle is an exceptionally rare condition with only a handful of documented cases in the literature. Isolated instances of ankle synovial chondromatosis have been reported, and these cases have been managed using both open and arthroscopic techniques. Arthroscopic intervention offers potential benefits such as improved joint access, reduced morbidity, and quicker rehabilitation and recovery. However, arthroscopic surgery might pose the risk of incomplete synovectomy or residual loose bodies.
Synovial chondromatosis of the ankle represents a chronic and rare ailment. Arthroscopic treatment stands out as an effective and dependable solution, offering various potential advantages over open surgery. This case report is presented due to the rarity and clinical significance of the condition.
Synovial chondromatosis of the ankle joint: 2 cases treated by open arthrotomy and synovectomy
2021, Foot
Citation Excerpt :
While this condition most often affects larger joints, the foot and ankle are not immune from SC, as involvement of the subtalar, calcaneocuboid, and metatarsophalangeal joints has been documented [1,3]. There is a predilection for males to present with SC more frequently than females, at a reported a 2:1 ratio, [1,5–7,9] most commonly between the third and fourth decades of life [9,10]. SC can usually be diagnosed through plain radiographs [2,7,10,12].
Synovial chondromatosis is a rare condition consisting of metaplasia of the synovial tissue that usually presents in large joints such as the knee and hip. The reported occurrence of synovial chondromatosis in the foot and ankle joints is rare in the literature. In this case report, the successful surgical management of two patients presenting with this condition using open ankle arthrotomy & synovectomy is described. These two cases are presented to provide added depth to the current literature, as well as presenting a review of published literature to further guide clinicians in the management of this rare condition.
4 (case study).
Tenosynovial osteochondromatosis of the flexor hallucis longus tendon treated by tendoscopy
2015, Journal of Foot and Ankle Surgery
Primary synovial chondromatosis: an elemental investigation of a rare skeletal pathology
2022, Folia Morphologica (Poland)
Anterior and Posterior Arthroscopic Treatment of Primary Synovial Chondromatosis of the Ankle
2021, Foot and Ankle International
Synovial chondromatosis of the foot: Two case reports and literature review
2019, World Journal of Orthopedics

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Case ReportAsymptomatic Synovial Chondromatosis of the Ankle: An Incidental Finding

Abstract

Section snippets

Case Report

Discussion

Acknowledgments

J Foot Ankle Surg

Tenosynovial (extra-articular) chondromatosis: an analysis of 37 cases of an under recognized clinicopathologic entity with a strong predilection for the hands and feet and a high local recurrence rate

Am J Surg Pathol

Imaging of synovial chondromatosis with radiologic-pathologic correlation

RadioGraphics

Synovial osteochondromatosis involvement in post-traumatic ankle injury

J Am Podiatr Med Assoc

Synovial chondromatosis of the foot

Clin Orthop Relat Res

Bone erosion in synovial chondromatosis

Radiology

Case Report
Asymptomatic Synovial Chondromatosis of the Ankle: An Incidental Finding