PMC5546645_01
The MRI examination shows the extension of tenosynovial chondromatosis.
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Both examinations showed an important synovial reaction with a pseudo cyst of about 43 mm in diameter involving the radiocarpal and intercarpal joints as well as the sheath of the flexor, the extensor tendons and abductor of the thumb (Figure 1).
The dorsal access shows gelatin-like foreign bodies originating from tendon sheaths.
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Because of the difficulty in carrying out a complete excision of the numerous nodules, we performed a second surgical step using the volar access to complete the excision and radical synovectomy (Figure 2).
Histopathologic section shows nodules of cartilaginous tissue.
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Microscopically, we observed both mature and immature cartilaginous tissue apposition in foci surrounded by fibrous tissue and linked to synovial tissue (Figure 3).
The images show the double surgical access at 2 years of follow-up. (a) excision of the dorsal wrist plane; (b) excision of the volar wrist plane.
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Two years of follow-up did not reveal any post-surgery complications, reoccurrence of pathology without pain or main functional limitation of wrist (Figure 4).