Case Report
Diagnosis and Arthroscopic Treatment of Primary Synovial Chondromatosis of the Shoulder

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Abstract

Primary synovial chondromatosis of the shoulder is a rare condition. We present the case of a 24-year-old man with a 6-month history of right shoulder pain and decreased range of motion. Computed tomography and magnetic resonance imaging findings led us to the diagnosis of synovial chondromatosis of the shoulder. Arthroscopy revealed loose bodies in the glenohumeral joint, the biceps tendon sheath, and the subscapularis recess. Active intrasynovial proliferation of the axillary pouch was noted. All loose bodies were removed arthroscopically, and partial synovectomy was performed. Histologic examination confirmed the diagnosis of primary synovial chondromatosis. We recommend arthroscopic treatment for synovial chondromatosis of the shoulder because of low morbidity and early functional return.

Section snippets

Case Report

A 24-year-old right hand–dominant man presented with a 6-month history of right shoulder pain during daily activity and decreased range of motion. There was no history of trauma or other underlying medical problems. Physical examination of the right shoulder revealed limited forward flexion to 70°, abduction to 20°, internal rotation to 40°, and external rotation to 30° with respect to the uninvolved side. There were no signs of inflammation or instability. Tenderness was noted over the biceps

Discussion

Primary synovial chondromatosis of the shoulder is a rare condition with an undefined etiology. It most commonly involves the knee joint, followed by the hip, elbow, wrist, ankle, and shoulder.7, 8 It is characterized by primary benign cartilaginous synovial metaplasia and leads to formation of calcified loose bodies. Milgram7 classified synovial chondromatosis into 3 separate phases of the disease: (1) active intrasynovial process without loose bodies, (2) transitional phase with active

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Cite this article as: Tokis AV, Andrikoula SI, Chouliaras VT, Vasiliadis HS, Georgoulis AD. Diagnosis and arthroscopic treatment of primary synovial chondromatosis of the shoulder. Arthroscopy 2007;23:1023.e1-1023.e5 [doi:10.1016/j.arthro.2006.07.009].

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