These patients may be asymptomatic, with SOC merely as an incidental finding at imaging. Complications
Malignant transformation to synovial chondrosarcoma. This is a very rare complication occurring in chronic cases. Treatment entails synovial excision and total joint replacement.Clicking, grating, or locking may result from acute mechanical problems due to intra-articular bodies within the affected joint. Locking may destroy articular cartilage, resulting in secondary osteoarthritis. Symptoms such as joint stiffness and aching are the result of osteoarthritis that sets in after years of persistent joint irritation. Diagnosis
Radiography
Typical finding is of multiple, smooth, oval-shaped calcified masses within the joint space or bursa. They have a characteristic popcorn-ball appearance of calcified cartilage. With serial imaging, masses may be found to change in size, disappear, or migrate to recessed areas of the joint. They may pass from the main joint cavity into a neighboring synovial cyst. For this reason, a mass may not be appreciated within the actual joint space itself.Additional radiographic findings include joint effusion and degenerative changes such as joint space narrowing, subchondral sclerosis, and osteophyte formation. Computed tomography
CT is best utilized in earlier stages of the disease process before cartilaginous bodies have calcified (become filled with calcium). CT can effectively detect non-calcified masses or those with only minimal calcification, which allows the radiologist to distinguish this condition from a simple joint effusion. Magnetic resonance imaging
MR appearance depends on the composition of the intra-articular body. Entirely cartilaginous bodies will appear isointense to muscle on T1 and hyperintense to muscle on T2 weighted images.
Patients who have recurrent intra-articular bodies or in whom the entire synovial lining is metaplastic require total synovectomy. References
Further reading
FletcherCDM, UnniKK, MertensF, editors. Pathology and genetics of tumours of soft tissue and bone. World Health Organization classification of tumours. Lyon: IARC Press, 2002. Bianchi S, Martinoli C (July 1999). "Detection of loose bodies in joints". Radiol. Clin. North Am. 37 (4): 679–90. doi:10.1016/S0033-8389(05)70123-8. PMID 10442075. Coles MJ, Tara HH (January 1997). "Synovial chondromatosis: a case study and brief review". Am. J. Orthop. 26 (1): 37–40. PMID 9021034. Crotty JM, Monu JU, Pope TL (March 1996). "Synovial osteochondromatosis". Radiol. Clin. North Am. 34 (2): 327–42, xi. PMID 8633119. Maurice H, Crone M, Watt I (1 November 1988). "Synovial chondromatosis". J Bone Joint Surg Br. 70 (5): 807–11. doi:10.1302/0301-620X.70B5.3192585. PMID 3192585. Milgram JW, Gilden JJ, Gilula LA (January 1996). "Multiple loose bodies: formation, revascularization, and resorption. A 29-year followup study". Clin. Orthop. Relat. Res. (322): 152–7. doi:10.1097/00003086-199601000-00019. PMID 8542691. S2CID 25265519. == External links ==