29-year-old Female With Left Knee Pain - Page #4
 

Working Diagnosis:
Synovial Chondromatosis

Treatment:
Initial improvements were seen with cortisone injections and physical therapy. Ultimately, conservative therapy was ineffective without arthroscopic synovectomy.

Outcome:
Following synovectomy, she successfully participated in physical therapy with resolution of her symptoms.

Follow up MRI at 3-4 months post-operatively showed multifocal synovial chondromatosis of the left knee with the overall volume of synovial hyperplasia without significant changed compared to the pre-operative MRI.

At the same time, she had no recurrence of her symptoms and had no ongoing pain or functional limitations. She was exercising regularly, and had lost 9 pounds from her pre-operative weight.

She was scheduled for annual surveillance MRIs and clinic evaluations, but has chosen to forego further evaluation, as she is currently asymptomatic.

Editor's Comments:
Synovial chondromatosis, also known as Reichel's or Reichel-Jones-Henderson syndrome, is a very rare condition of metaplasia of cartilage that develops within the synovial membrane of joints, bursae, or tendon sheaths. It primarily occurs in middle-aged individuals, with a male-to-female ratio of 2:1. Medical therapy includes modalities that help with symptoms, such as nonsteroidal anti-inflammatory medications and physical therapy. Surgical therapies are for those with persistent symptoms after medical therapies have been tried, which includes arthroscopic examination and excision of loose bodies with limited synovectomy of the involved segments.

References:
Emedicine

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