PMC9826556_01
AP, Grashey, and scapular Y views on initial presentation demonstrating multiple small rounded mineralized foci in the axillary and subcoracoid recesses.
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F1
The patient's primary care physician had ordered X-rays of the shoulder which demonstrated multiple calcified loose bodies in the axillary recess (Fig. 1). Erosions were also seen posteriorly on the scapular Y-view (Fig. 1c).
Axial, sagittal, and coronal slices from the T2 fat-saturated proton dense sequence demonstrating several loose bodies of relatively uniform size in the subcoracoid bursa, superior subscapular recess, and anterior to the glenoid.
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F2
MRI demonstrated several loose bodies in the subcoracoid bursa (Fig. 2).
Arthroscopic views demonstrating several small intra-articular loose bodies (first two images), removal through a large hip arthroscopy at the 7 o'clock position (third image), and several loose bodies measuring nearly 0.5 cm (fourth image).
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F3
Several loose bodies were found intra-articularly (Fig. 3a, 3b). The loose bodies were removed through a large (hip arthroscopy) posteroinferior portal with a high inflow to act as a suction (Fig. 3c.) Extensive debridement around the rotator interval was performed to adequately remove all subcoracoid loose bodies. The specimens were sent for gross diagnosis to pathology and were described as multiple well-circumscribed gray-white portions of firm nodular tissue that was 3.5 cm in greatest dimension when aggregated (Fig. 3d).
AP, scapular Y, and axillary lateral views demonstrating near complete resolution at 10 months post-operatively. An incidentally found large smooth scalloping lesion along the anterior aspect of the proximal humeral physis and a smaller lesion posteriorly can be seen.
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F4
Follow-up X-rays demonstrated resolution of the chondromatosis; however, bony erosions along the anterior and posterior humeral head were seen (Fig. 4).
Radiographs 48 months postoperatively demonstrating resolution of the chondromatosis. The bony erosions seen priorly are most notable on the axillary lateral view .
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F5
Repeat radiographs demonstrated resolution of the synovial chondromatosis, yet the priorly seen bony erosions were again noticed (Fig. 5).