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Case Reports
. 2017 Dec 23;9(12):e1983.
doi: 10.7759/cureus.1983.

Arthroscopic Treatment of Synovial Chondromatosis in the Ankle Joint

Daniel R Kunzler  1 , Pejma Shazadeh Safavi  2 , Brittney J Warren  3 , Cory F Janney  4 , Vinod Panchbhavi  3
Affiliations
Case Reports

Arthroscopic Treatment of Synovial Chondromatosis in the Ankle Joint

Daniel R Kunzler et al. Cureus. .

Abstract

Synovial chondromatosis of the ankle is rare and sparsely documented. Traditional surgical intervention is open loose body excision and synovectomy. Upon literature review, only two other cases were found to be managed arthroscopically. We report a case of synovial chondromatosis in a 54-year-old man leading to pain and limited range of motion of his ankle. This unique case of extensive nodule formation was treated via a three-port arthroscopic approach. Removal of loose bodies and synovectomy were successfully performed arthroscopically. A total of 76 loose bodies were removed and synovectomy performed using a 3.5 mm diameter full radius shaver. This case demonstrates that a three-port arthroscopic approach can provide adequate treatment while maintaining the superior risk profile inherent to arthroscopic intervention.

Keywords: ankle; arthroscopy; loose bodies; synovectomy; synovial chondromatosis.

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Conflict of interest statement

The authors have declared financial relationships, which are detailed in the next section.

Figures

Figure 1
Figure 1. Preoperative Radiographs.
Preoperative radiographs demonstrate innumerable subcentimeter loose bodies within the tibiotalar joint. Anteroposterior radiograph shown on the left, and lateral radiograph shown on the right with loose bodies outlined by black circle.
Figure 2
Figure 2. Left Ankle Joint Arthroscopic View.
Left ankle joint arthroscopic view shows multiple cartilaginous loose bodies.
Figure 3
Figure 3. Gross Finding of Loose Bodies.
Several loose bodies shown after removal from tibiotalar joint via irrigation or blunt grasper.
Figure 4
Figure 4. Intraoperative Fluoroscopic Imaging.
Removal of all loose bodies was verified by intraoperative fluoroscopic imaging. Anteroposterior radiograph shown on the left, and lateral radiograph shown on the right.
Figure 5
Figure 5. Left Ankle Joint Histology.
Left ankle joint histology shows multiple well-defined nodules consisting of hyaline cartilage containing clusters of benign-appearing chondrocytes, some with degenerative atypia, consistent with synovial chondromatosis. One cluster is outlined by black ellipse. Black arrows highlight benign chondrocytes.
See this image and copyright information in PMC

References

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