Extra-Articular Tenosynovial Chondromatosis of the Finger: A Case Series Study of Three Cases, One Including Excessive Osseous Invasion

Abstract

Background:Synovial chondromatosis is characterized by cartilaginous metaplasia in synovial tissues. Extra-articular tenosynovial chondromatosis is considered to be an anatomical counterpart of articular synovial chondromatosis. Extra-articular tenosynovial chondromatosis occurs preferentially in the hand, although its frequency is low.Results:We report three cases of extra-articular tenosynovial chondromatosis. A 65-year-old female presented with a history of symptoms over 40 years related to the dorsum of her index finger (Case 1), A 46-year-old female presented with a 6-month history of symptoms at the volar surface of her middle finger (Case 2), and a 66-year-old male presented with a 3-month history of symptoms in a dorsal ring finger. Case 2 had evidence of ossification, which could be classified as osteochondromatosis. Interestingly, the index finger lesions (Case 1) were accompanied by excessive bone involvement. The signal intensity of T2-weighted magnetic resonance imaging varies from low to high, possibly reflecting histological variations, such as ossification and fatty tissue changes. All lesions were resected without complications.Conclusion:Variations in anatomical sites suggest that overuse or mechanical overloading was not causative. Extensive involvement of the nearby tendon and joint capsule, as well as the bone, would require attention during the resection. Preoperative analysis of images is important, not only for the diagnosis, but also to assess the extent of the lesion, particularly given the complex anatomy of the finger.

Tenosynovial chondromatosis of the flexor pollicis longus tendon: A subtype of primary synovial chondromatosis

“…4 a and b. There have been similar cases of tenosynovial chondromatosis published in the literature [4] , [5] , [6] , [7] , [8] , [9] , [10] . Our case is unusual because of the lack of calcification, which is seen in 90% [10] .…”

Carpal tunnel syndrome caused by synovial osteochondromatosis of the finger flexor tendon

“…[4,5] However, SOC rarely affects the temporomandibular joint, spinal facet joint, acromioclavicular joint, metatarsophalangeal/interphalangeal joint, wrist joint, ankle joint, or biceps tendon and so on. [6–8]…”

Extra-articular osteochondromatosis: A collection of four clinical cases of different localization

“…[5] Intra-articular synovial osteochondromatosis usually occurs in young men, in contrast with the extra-articular synovial chondromatosis, which has no age or gender predilection. [6] Two types of synovial osteochondromatosis are recognized: primary and secondary forms.…”

“…In extra-articular osteochondromatosis, the mass can be contiguous to a joint or at a variable distance when localized in bursa or tendon sheath. [5] The sensitivity of radiographic detection depends on the size of cartilaginous nodules. CT is more sensible for the localization of mass and more reliable for the relationship with joints.…”