Title: Failure of arthroscopic removal of loose bodies in knee mandating synovectomy, later diagnosed histopathologically as synovial chondromatosis (Reichel- Jones-Henderson syndrome)

Biography:

Ajay Trivedi is a third year orthopedic resident in NHL Municipal Medical College and Shree Vadilal Sarabhai General Hospital, Ellisbridge, Ahmedabad, Gujarat, India. He is from Ahmedabad and went to Nutan Vidhyavihar Higher secondary school. He has completed MBBS (medicine and surgery bachelor) from B J Medical College, Civil Hospital, Ahmedabad under Gujarat University in the year  2016 and took admission in the aforementioned institute (NHL MMC)  for postgraduate degree course of master of surgeon in orthopedics and traumatology

Abstract

Introduction: Synovial chondromatosis is an uncommon, idiopathic, generally benign condition, mostly monoarticular, most commonly involving the synovial membranes of large joints, most commonly the knee joint, with preponderance in males of 4th to 6th decade. Presence of multiple cartilaginous nodules and loose bodies in the synovium or cavity are characteristic. Histopathology is confirmatory. Removal of loose bodies and complete synovectomy is the mainstay of treatment.

Case Report:

Here we present a case of 38 year old male with swollen stiff right knee joint for 2 years, presenting with sudden locking sensation. After clinical and radiological assessment, diagnostic arthroscopy was planned which was converted into an open synovectomy, in lieu of large loose bodies, histopathological examination of which confirmed the diagnosis.

Conclusion: Primary synovial chondromatosis is an uncommon, highly destructive and aggressive disease. Histopathology is confirmatory. Removal of loose bodies with stripping of and complete excision of the synovium remain the mainstay of treatment.