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Synovial osteochondromatosis

Case contributed by Mohammad Farghali Ali Tosson
Diagnosis certain

Presentation

Left knee pain, trauma 8 years ago.

Patient Data

Age: 30 years
Gender: Male
x-ray

Several intra-articular calcified loose bodies

mri

There are numerous variable-sized intra-articular loose bodies; some of them are showing intermediate to high signal intensity that is of cartilage.  Others have low signal intensity at the periphery, which represents ossification.

Haziness of the ACL fibers with loss of normal signal intensity and fiber continuity suggesting a tear.

Abnormal oblique linear hyperintense signal is seen within the anterior horn of the medial meniscus disrupting its articular surface, representing a tear.

The medial collateral ligament is surrounded by edema, with normal thickness and signal intensity of its fibers and no loss of continuit - findings are compatible with medial collateral ligament injury grade I - minor sprain.

Moderate supra-patellar effusion.

Case Discussion

The findings mentioned in this case are compatible with synovial chondromatosis. In view of the patient's age and the absence of severe degenerative process of the joint, primary synovial chondromatosis is preferred over the secondary counterpart which is a related to a degenerative process.

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