Synovial chondromatosis

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Synovial chondromatosis
Diagnosis in short

Loose body. H&E stain.

LM hyaline cartilage +/- lobular surface +/-lacunae with binucleate cells, +/-nuclear atypia (moderate to severe), +/-synovial hyperplasia, bone
LM DDx chondrosarcoma, osteoarthritis
Site joints - classically knee or hip

Symptoms pain
Prognosis benign
Treatment removal of loose bodies

Synovial chondromatosis is a relative common pathology of the joint. It is also known as synovial osteochondromatosis.

Loose body, loose bodies, rice bodies and joint mice redirect to this page.

General

  • Benign.
    • Malignant transformation rare <5%.[1]
  • Classically location: knee.[1]
    • Hip next most common site.
  • Usually adults.
  • Prevalence: male > female.

Note:

  • This is a clinicoradiologic diagnosis.

Gross/radiology

  • Intraarticular calcifications.
  • Diffuse involvement of the joint.
  • +/-Loose bodies in the joint (AKA joint mice).

Image

www:

Microscopic

Features:[1]

  • Hyaline cartilage +/- lobular surface.
    • +/-Lacunae with binucleate cells.
    • +/-Nuclear atypia - moderate to severe.[2]
  • +/-Synovial hyperplasia - ribbon like tissue with an epithelium that has eosinophilic cytoplasm.
  • Bone.

DDx:

Images

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Synovium, Left Knee, Biopsy:
     - Synovium with mild chronic inflammation.
     - Cartilage with ossification, compatible with loose bodies/rice bodies.
     - NEGATIVE for evidence of malignancy.

Block letters

LOOSE BODIES, RIGHT ELBOW, REMOVAL:
- FRAGMENTS OF BONE WITH CARTILAGE AND SYNOVIAL TISSUE COMPATIBLE WITH LOOSE BODIES.
TISSUE, CAPSULE LEFT ELBOW, REMOVAL:
- DEGENERATIVE JOINT DISEASE.
- SYNOVIAL HYPERPLASIA WITHOUT SIGNIFICANT INFLAMMATION.
- ROUND BODIES CONSISTING OF BENIGN BONE WITH A FATTY MARROW, AND FIBROUS
  AND CARTILAGINOUS SURFACE, COMPATIBLE WITH LOOSE BODIES.
- NEGATIVE FOR MALIGNANCY.
LOOSE BODY, LEFT KNEE, REMOVAL:
- BENIGN BONE WITH FIBROTIC SYNOVIAL MEMBRANE, CONSISTENT WITH LOOSE BODY.

Micro

The sections show multiple fragments of tissue consisting of bone covered by hyaline cartilage and associated with synovial hyperplasia.

There is no appreciable nuclear atypia or mitotic activity.

See also

References

  1. 1.0 1.1 1.2 Murphey, MD.; Vidal, JA.; Fanburg-Smith, JC.; Gajewski, DA.. "Imaging of synovial chondromatosis with radiologic-pathologic correlation.". Radiographics 27 (5): 1465-88. doi:10.1148/rg.275075116. PMID 17848703.
  2. URL: http://www.webpathology.com/image.asp?n=3&Case=369. Accessed on: 10 December 2012.