Rare case of extra-articular with Intra-articular synovial chondromatosis of right shoulder in 23 years old female

Abstract

Introduction: Synovial chondromatosis (SC) is a rare condition in which cartilaginous masses are formed by metaplasia of the synovial membrane with infrequent involvement of shoulder joint and extraarticular presence.  It characteristically involves single joint but extra-articular forms in the form of tendon sheath or bursal involvements have been rarely reported. It usually occurs in third-fifth decade and shoulder joint involvement is infrequent. Franklin first reported extra articular synovial chondromatosis in 1977. SC involving shoulder joint is rare but extra articular involvement is very rare.

Case Report: We present a case of Synovial chondromatosis 23 year-old-, right-handed-dominant female had presented with complain of multiple swelling, decreasing range of motion for 5 months and occasionally locking of right shoulder.

Magnetic Resonance Imaging was suggestive of multiple loose bodies in joint capsule with surrounding subacromial bursa and sub deltoid region. Extra articular loose bodies were removed by delto-pectoreal approach followed by shoulder arthroscopic was performed for synovectomy and removal of intra articular loose bodies.

Conclusion: Mono articular synovial chondromatosis with extra articular involvement of shoulder is rare case. We believe the success of arthroscopic surgery in selected patients with synovial chondromatosis. Extra articular lesion should not be neglected and treated aggressively with aim of open excision with through synovectomy. We further emphasize the need to follow these patients to detect recurrence or malignant transformation.

Keywords: Synovial chondromatosis