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Secondary osteochrondromatosis

Case contributed by Ian Bickle
Diagnosis almost certain

Presentation

Knee pain with locking. Meniscal?

Patient Data

Age: 35
Gender: Male

Numerous sizebable osteophytes, chiefly in relation to the femoral condyle, with narrowing of the patellofemoral joint space.  The largest measures 1.2cm. 

Minor chondromalacia of the patellofemoral joint.

Multiple intra-articular foreign bodies, measuring upto 11mm. Several lie posteriorly in the popliteal fossa.

Small joint effusion.

No significant subchondral cyst formation.

Thickened ACL with intratendinous high signal.  Normal extensor mechanism. Normal collateral ligaments.

Normal PCL.

Normal menisci.
 

An MRI was also performed 3 years prior, with very similar, albeit slightly less pronounced findings.

The patient is of a relative young age with no prior surgery or trauma at this stage.

Case Discussion


The appearances in keeping with advanced degenerative change, very much in excess for the patient's age. 

The nature of the osteophytes along with the absence of a meniscal injury, suggests the intra-articular foreign bodies are bone derived.  Therefore this is most fitting with secondary osteochondromatosis.

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