Primary and secondary synovial chondrometaplasia: Histopathologic and clinicoradiologic differences

doi:10.1016/S0046-8177(79)80050-7

Human Pathology

Volume 10, Issue 4, July 1979, Pages 439-451

https://doi.org/10.1016/S0046-8177(79)80050-7 Get rights and content

Abstract

One hundred thirty-six cases diagnosed clinically as either synovial chondrometaplasia or osteocartilaginous loose bodies were reviewed. On the basis of the histopathologic peculiarities, the cases were grouped into two distinct categories, primary and secondary synovial chondrometaplasia, comprising 10 and 126 cases, respectively. In each group there was synovial chondrometaplasia but the histologic patterns were dissimilar. In cases of secondary synovial chondrometaplasia the initiating factors were usually obvious and the lesions were nonaggressive. Primary synovial chondrometaplasia, on the other hand, was aggressive and was associated with a high incidence of recurrence.

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Primary synovial chondromatosis of the shoulder followed for 11 years after arthroscopic surgery: A case report
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We report a case of primary synovial chondromatosis of the shoulder (Milgram classification, stage III) in a 25-year-old woman. She underwent arthroscopic removal of multiple loose bodies and partial synovectomy. Histological findings revealed primary synovial chondromatosis. Eleven years after surgery, the clinical results have been excellent with no recurrence, although X-ray showed slight degenerative changes of the glenohumeral joint. This is the first report of primary synovial chondromatosis of the shoulder observed over a 10-year follow-up period after arthroscopic surgery.
Synovial chondromatosis: a case series and review of the literature
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This case series reviews 2 patients worked up and treated for unilateral synovial chondromatosis of the temporomandibular joint (TMJ). The first was a 58-year-old female evaluated and treated for synovial chondromatosis of the left TMJ using an arthrotomy of the joint to remove the cartilaginous and osteocartilaginous nodules. The second is a 63-year-old male who was evaluated and treated for synovial chondromatosis of the right TMJ with the removal of extracapsular masses and an arthrotomy with intra-joint removal of nodules. Six-year radiographic follow-up demonstrated no recurrence of the pathology in his case. The cases are reviewed in this article, along with a current review of the literature.
MRI Assessment of Benign Tumor And Tumor-Like Synovial Diseases
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Citation Excerpt :
SSC affects mostly the knee and hip and generally occurs in older patients compared to PSC.5 On SSC, histopathology shows metaplastic cartilaginous nodules, evenly distributed uniform chondrocytes, and no cytologic atypia characteristic of PSC.18 Concentric rings of calcification in the nodules of cartilage may have been present in SSC due to growth at the surface and subsequent internal calcification, which are not seen in the primary disease and may be regarded as a marker of the secondary form.5,18
A case of deposition of calcium pyrophosphate dehydrate crystals with synovial chondromatosis in the temporomandibular joint
2022, Journal of Oral and Maxillofacial Surgery, Medicine, and Pathology
Calcium pyrophosphate dehydrate deposition disease (CPPDd) is a benign disorder that is typically characterized by excessive presence, crystallization, and deposition of calcium pyrophosphate dehydrate (CPPD) crystals in the synovium, articular cartilage, and surrounding soft tissues. On the other hands, synovial chondromatosis (SC) is also a benign disease that is characterized by synovial tissue that has undergone chondrogenesis and forms cartilaginous nodules that may become loose bodies in the joint space. A 58-year-old Japanese man was referred to our center with a chief complaint of chronic pain in the preauricular region and a 3-year history of trismus. Radiological examination of the affected TMJ revealed chondrocalcinosis. Aspiration of synovial fluid and irrigated the space with pumping procedure were performed in the superior joint space to confirm the diagnosis. However, only synovial tissue was detected, which did not lead to a diagnosis, and there was minimal improvement in his symptoms. We enucleated the tumor by open TMJ surgery. Histopathologically, we diagnosed that coexisting CPPDd and SC in the superior joint space.
Our experience showed that “Don't judge a specimen based on the findings of a joint puncture”, and keep in mind that some cases may be coexisting. Improper handling of specimen may result in underdiagnosis.
Secondary Extra-Articular Synovial Osteochondromatosis with Involvement of the Leg, Ankle and Foot. An Exceptional Case
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La osteocondromatosis sinovial (OCS) extraarticular es una enfermedad benigna muy infrecuente cuya etiología puede ser primaria o secundaria a una enfermedad preexistente o tras traumatismos. El diagnóstico puede realizarse con radiografía simple y TC, siendo necesaria la RM para evaluar el componente de partes blandas no mineralizado y valorar la extensión. Debe confirmarse con estudio anatomopatológico mediante biopsia o resección. Tiene hasta un 5% de posibilidades de experimentar transformación maligna. El tratamiento de elección de la forma extraarticular extensa es quirúrgico mediante resección abierta.
El caso presentado ilustra una forma de aparición atípica de la OCS extraarticular secundaria con afectación múltiple de la pierna, el tobillo y el pie.
Extraarticular synovial osteochondromatosis is a very rare benign disease whose aetiology may be primary or secondary to pre-existing pathology or after trauma. The diagnosis can be made with plain radiography and CT, and MRI is necessary to evaluate the non-mineralized soft tissue component and assess extension. It must be confirmed with a pathological study by biopsy or resection. There is up to a 5% chance of malignant transformation. The treatment of choice for the extensive extra-articular form is surgery by open resection.
The case presented illustrates an atypical form of secondary extraarticular OCS with multiple involvement of the leg, ankle and foot.
Imaging features of synovial chondromatosis of the temporomandibular joint: a report of 34 cases
2021, Clinical Radiology
Citation Excerpt :
Primary SC shows the pathological features of chondrocyte pleomorphism, atypia, and mitotic activity, which are rarely found in secondary SC.10,35,36 Secondary SC, which is caused by an underlying primary condition, such as a degenerative joint disease, exhibits a more uniform degree of cellularity, a laminar arrangement of the cartilage matrix, and a lack of clustering of chondrocytes.10,35–37 By those pathological standards, distinguishing primary SC from secondary SC usually presents no problems.10,37
To investigate the imaging features of synovial chondromatosis of the temporomandibular joint (TMJ), which is a rare benign arthropathy with cartilaginous proliferation.
Computed tomography and magnetic resonance imaging examinations of 34 patients with histopathologically confirmed primary synovial chondromatosis of the TMJ were reviewed retrospectively. Imaging features including the lesion epicentre, destruction/sclerosis of surrounding bone, calcification, periosteal reaction, osteophyte, lesion size, and joint space dimensions were assessed.
Thirty-one of thirty-four patients (91.2%) showed the superior joint space as the lesion epicentre. For the mandibular condyle, more than one-third of patients (14/34; 41.2%) showed no destruction, and more than half of patients (19/34; 55.9%) showed no sclerosis. Conversely, >70% of patients showed destruction and sclerosis of the articular eminence/glenoid fossa, while >80% of patients (28/34; 82.4%) presented with various calcifications, including the ring-and-arc (9/34; 26.5%) and popcorn (13/34; 38.2%) types. The mean joint space on the affected side was significantly larger than that of the unaffected side (p<0.001). More than three-fourths of patients (76.9%) experienced no interval increase in lesion size during an average of 1.6 years of follow-up.
Synovial chondromatosis of the TMJ demonstrated several imaging features, including the lesion centre being located in the superior joint space, resultant articular eminence/glenoid fossa-oriented bone changes, ring-and-arc and popcorn calcification, joint space widening, and self-limiting growth. These imaging features may be helpful in differentiating synovial chondromatosis from other lesions of the TMJ.

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^*: Assistant Pathologist, The Hospital for Special Surgery, New York, New York.

^†: Resident in Orthopaedic Surgery, The Hospital for Special Surgery, New York, New York.

^‡: Associate Professor of Pathology, Cornell University Medical College. Chief, Orthopaedic Surgery, The Hospital for Special Surgery, New York, New York.

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Primary and secondary synovial chondrometaplasia: Histopathologic and clinicoradiologic differences

Abstract

Reactive and neoplastic changes in synovial tissues

Proc. Inst. Med. (Chicago)

Synovial chondrosarcoma. Report of a case

J. Bone Joint Surg.

A study of loose bodies composed of cartilage and bone occurring in joints, with special reference to their pathology and etiology

Brit. J. Surg.

Chondromatosis of the joints

Arch. Surg.

Synovial chondrosarcoma

Cancer

Synovial chrondromatosis

J. Bone Joint Surg.

Loose body formation in synovial osteochondromatosis

J. Bone Joint Surg.

Synovial chondrosarcoma of the knee joint

J. Bone Joint Surg.

Osteochondromatosis of the hip joint

J. Bone Joint Surg.