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Secondary synovial osteochondromatosis

Case contributed by Varun Babu
Diagnosis almost certain

Presentation

Restricted terminal flexion of knee.

Patient Data

Age: 60 years
Gender: Male

Osteodegenerative changes are seen extensively in all three compartments of the knee joint, predominantly involving the medial compartment in the form of reduced joint space, medial joint space vacuum, outer margin tibiofemoral condyle and patellar pole osteophytes. Multiple well defined round loose bodies are seen in posterior joint space of tibiofemoral joint with moderate effusion. 

A chronic Baker cyst is present with multiple loose bodies within it.  Moderate prepatellar bursitis. 

Case Discussion

This CT study typifies a case of chronic osteodegeneration of the knee joint. Loose bodies are remnants of denuded articular cartilage that get nourished by the synovium. When it enlarges, the center loses blood supply and calcifies. They are primary identified as a physical hindrance in movements exhibiting mass effect in whichever space they are confined to. 

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