Synovial Chondromatosis

What is Synovial Chondromatosis?

Synovial chondromatosis is a disease affecting the synovium, the membrane around the inside of the hip joint. The condition is characterized by the presence of many loose cartilage balls (chondromata), ranging from one to dozens. It can affect many different joints, but the hip is a more common location.

Types

There are two types of synovial chondromatosis:

• Primary synovial chondromatosis occurs for unknown reasons. It can lead to osteoarthritis.
• Secondary synovial chondromatosis is the most common type. It occurs when you already have joint damage from conditions like arthritis, osteonecrosis (avascular necrosis), or osteochondritis dissecans.

Causes

Loose bodies occur if there is bleeding within the joint, or death of tissues lining the joints associated with tuberculosis, osteoarthritis, and rheumatoid arthritis. Other causes include fractures, trauma, bone and cartilage inflammation, and benign tumors of the synovial membrane.

Symptoms

The primary symptoms of loose bodies in the hip are:

• Sharp pain when the hip is flexed in a particular position.
• Catching or locking of the hip joint.
• A dull ache.

Diagnosis

The Doctor will perform a physical examination and evaluate your symptoms.

An X-ray usually detects loose nodules, but smaller ones might not show up. If an X-ray doesn’t find any nodules, you may receive a CT Scan or an MRI to get a more detailed image of your joint.

These imaging tests aid the diagnosis. They also can show signs of osteoarthritis and fluid in your joint.

Treatments

Surgical Treatment:

In patients where loose bodies are present within the hip and cause ongoing hip pain, surgery will need to be performed to remove the loose fragments. Leaving loose fragments in the joint may lead to further deterioration of the articular cartilage.

Surgery involves removing the tumors in addition to part or all of your affected synovium tissue (a synovectomy). After surgery, you may do physical therapy to regain your range of motion and strengthen the joint.

The surgery is typically an arthroscopic procedure. Arthroscopy incisions are smaller and cause less pain and scarring than the larger incisions used in an open procedure. Depending on the location of the nodule, you may get knee arthroscopy, shoulder arthroscopy, or arthroscopy on a different joint.

During an arthroscopic procedure, your healthcare provider:

• Makes several small incisions in your skin.
• Inserts a tiny camera device (arthroscope) into one opening.
• Inserts surgical instruments into the other openings.
• Views a video screen to perform the procedure and remove the growths.
• Removes the camera and instruments.
• Closes the incisions with dissolvable stitches or a bandage.

Recovery

Recovery from the removal of loose bodies in the hip occurs quite quickly. The Doctor will provide a well-supervised physical therapy program beginning immediately after surgery. Therapy will focus on slowly returning motion to the injured hip, followed by a progressive strengthening program to protect the repaired hip.