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Case Reports
. 2024 May 22;16(5):e60843.
doi: 10.7759/cureus.60843. eCollection 2024 May.

Management of Primary Synovial Osteochondromatosis in the Ankle Joint With a Combined Posterior-Anterior Arthroscopic Procedure: A Case Report

Rui Correia Cardoso  1 , Filipe Malheiro  2 , Bruno Pereira  2
Affiliations
Case Reports

Management of Primary Synovial Osteochondromatosis in the Ankle Joint With a Combined Posterior-Anterior Arthroscopic Procedure: A Case Report

Rui Correia Cardoso et al. Cureus. .

Abstract

Primary synovial osteochondromatosis (PSO), a seldom-seen synovial proliferative disease involving chondral metaplasia, presents a unique challenge when affecting the ankle joint. Controversy exists regarding whether a combined posterior-anterior approach with total synovectomy is necessary to avert recurrence or malignancy. An 18-year-old Caucasian male presented to the outpatient clinic with clinical and imaging findings indicative of a stage III PSO. The surgical intervention involved a combined posterior-anterior arthroscopic approach with the removal of multiple loose bodies and complete synovectomy, resulting in complete relief of symptoms without recurrence at the 12-month follow-up. Pathological examination confirmed the diagnosis. The management of PSO in the ankle joint using a combined posterior-anterior arthroscopic approach with complete synovectomy demonstrated effectiveness in this case. Regular follow-ups are essential for monitoring long-term outcomes and detecting potential recurrence or malignant transformation.

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

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Preoperative axial CT of the right ankle.
Figure 2
Figure 2. Preoperative sagittal CT of the right ankle.
Figure 3
Figure 3. Preoperative axial dual phase MRI of the right ankle.
Figure 4
Figure 4. Preoperative sagittal T2 MRI of the right ankle.
Figure 5
Figure 5. Arthroscopic view of the anterior ankle compartment showing multiple loose bodies.
Figure 6
Figure 6. Intraoperative fluoroscopy confirms the complete removal of radio-opaque loose bodies.
Figure 7
Figure 7. Intraoperative image showing multiple loose bodies removed arthroscopically from the ankle joint.
See this image and copyright information in PMC

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