Synovial chondromatosis simulating neoplastic degeneration of osteochondroma: findings on MRI and CT

Abstract

A case is presented of synovial chondromatosis within a bursal sac overlying an osteochondroma in a patient with osteochondromatosis. This condition presented with a symptomatic soft tissue mass containing calcified bodies. It can be mistaken clinically and radiographically for malignant degeneration of an osteochondroma with development of chondrosarcoma. Magnetic resonance findings have not previously been described in this entity and proved helpful in the preoperative diagnosis. Magnetic resonance imaging was also helpful in defining the extent of the lesion. Ultrasound and other imaging modalities are also discussed, including the pathologic basis for the radiographic findings.

Secondary synovial chondromatosis in a bursa overlying an osteochondroma mimicking a peripheral chondrosarcoma—a case report

“…However, the arising of a secondary SC within a bursa overlying an osteochondroma may be still more uncommon; we have found reports of only 7 cases (El-Khouri and Bassett 1978, Borges et al 1981, Schofield et al 1994, Wright et al 1997, Peh et al 1999). In the secondary SC, the loose bodies are within the joint and have the potential for slow growth by synovial metaplasia following proliferation of surrounding connective tissue (Milgram 1977, Villacin et al 1979, Saotome et al 1999.…”

“…CT may be more helpful, showing the lobulated pattern of the calcified nodules lying separately from the exostosis (El-Khouriand Bassett 1978). Post-contrast axial CT scan may show a fluid-filled bursa containing numerous dense loose bodies (Schofield et al 1994). Favoring SC, Peh et al (1999) demonstrated very well how a shift of the cartilaginous nodules can be seen if the patient is examined in prone and supine position.…”

“…Diagnosis based on clinical findings and imaging may be difficult because SC can mimic a peripheral chondrosarcoma in terms of symptoms and interpretation of radiographs and MRI (El-Khouri and Bassett 1978, Kenan et al 1993, Schofield et al 1994. The slow course, prolonged over a number of years, may be equally slow in low-grade chondrosarcoma.…”

Identification of a rare case of intra-articular osteochondroma manifesting as three loose bodies in a patient with hereditary multiple osteochondromas: A case report

“…Subsequently, Milgram and Dunn (19) used the term 'para-articular osteochondroma' to differentiate between intra-articular osteochondroma and synovial osteochondromatosis. Synovial osteochondromatosis typically includes multiple osteochondrous synovium nodules with loose bodies in the joint (21); the multiple lobules of proliferative cartilage originate in the synovial joint tissue. By contrast, para-articular osteochondromas originate from a cartilaginous metaplasia of the articular and para-articular connective tissues (22).…”

Glycosylphosphatidylinositols of Protozoan Parasites

“…Here, we summarize the progress in the chemical synthesis of GPIs, particularly in the context of development of a general and convergent synthetic strategy. Interested readers are also referred to comprehensive reviews focusing on chemical synthesis of GPI (53)(54)(55). Most syntheses of GPIs were performed in a linear fashion, i.e.…”