PMC7446550_01
Shoulder synovial chondromatosis. In shoulder physical examination, (a) forward elevation loss compared with contralateral shoulder, and (b) internal rotation to lumbosacral level. Radiograph showed (c) large amounts of loose bodies in subacromial space and severe degenerative changes of glenohumeral joint. MRI scans detected (d) a massive rotator cuff tear and cartilage erosion of glenohumeral joint. In shoulder arthroscopic inspection, (e) a massive RCT and proliferative synovium were observed, and (f) large-sized foci. After 24-month follow-up, (g) MRI scans showed no signs of recurrence. Pathohistological macroscopic (h) and microscopic examinations (i) were accomplished after surgery, and the results were consistent with synovial chondromatosis.
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The degrees of flexion, abduction, and external rotation of the shoulder were 80 , 50 , and 35 , respectively, and internal rotation was through the lumbosacral level (Figure 1(a) and (b)). X-ray of the shoulder and elbow revealed massive oval-shaped calcifications in the subacromial space (Figure 1(c)) and humeroradial joint (Figure 2(a)). Magnetic resonance imaging (MRI) revealed granular material in the subacromial area with the signal resembling skeletal bones (Figure 2(b)) as well as massive RCTs (Figure 1(d)). On entering the subacromial space, we detected several free bodies together with massive posterosuperior RCTs (Figure 1(e)), a thickened bursal synovium (Figure 1(f)), dislocated long head of the biceps tendon, and an intact subscapularis tendon. The loose bodies measured 6 cm in diameter (Figure 1(h)).
Elbow synovial chondromatosis. Preoperative radiology showed (a) several free bodies, mild degenerative changes of whole elbow joint, and (b) proliferative synovium in humeroulnar joint. In elbow arthroscopy, (c) several foci, proliferative synovium, and cartilage erosion were inspected. A plain X-ray was checked and showed (d) full relief of loose bodies. Macroscopic (e) and microscopic (f) characteristics were consistent with synovial chondromatosis.
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X-ray of the shoulder and elbow revealed massive oval-shaped calcifications in the subacromial space (Figure 1(c)) and humeroradial joint (Figure 2(a)). Magnetic resonance imaging (MRI) revealed granular material in the subacromial area with the signal resembling skeletal bones (Figure 2(b)) as well as massive RCTs (Figure 1(d)). The anteromedial and anterolateral portals were introduced for the synovectomy, and an anterior capsulotomy was performed to gain extension, while the standard posterior and posterolateral portals were used to remove the loose bodies and perform a thorough debridement (Figure 2(c) and (d)). Several free bodies measured 3 cm in diameter (Figure 2(e)).