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Radiology Case Reports Dec 2023We report a case of primary synovial chondromatosis of the shoulder (Milgram classification, stage III) in a 25-year-old woman. She underwent arthroscopic removal of...
We report a case of primary synovial chondromatosis of the shoulder (Milgram classification, stage III) in a 25-year-old woman. She underwent arthroscopic removal of multiple loose bodies and partial synovectomy. Histological findings revealed primary synovial chondromatosis. Eleven years after surgery, the clinical results have been excellent with no recurrence, although X-ray showed slight degenerative changes of the glenohumeral joint. This is the first report of primary synovial chondromatosis of the shoulder observed over a 10-year follow-up period after arthroscopic surgery.
PubMed: 37766833
DOI: 10.1016/j.radcr.2023.08.104 -
International Journal of Surgery Case... Oct 2023Primary Synovial chondromatosis is a rare disease characterized by metaplastic cartilaginous nodules originating from the synovium, which rarely involves the ankle...
INTRODUCTION AND IMPORTANCE
Primary Synovial chondromatosis is a rare disease characterized by metaplastic cartilaginous nodules originating from the synovium, which rarely involves the ankle joint. To date, there has been a limited number of reported cases regarding the arthroscopic treatment of this disease, which can be attributed to its rare incidence. This article aims to illuminate the advantages and challenges of this technique by presenting a case study. Furthermore, we delve into the existing literature to assess the different treatments used for this disease and their outcomes.
CASE PRESENTATION
A 59-year-old male patient presented with ankle pain, swelling and limited dorsiflexion. Subsequent imaging findings led to the diagnosis of anterior ankle primary synovial chondromatosis. Following this, the patient underwent arthroscopic assisted loose body removal and partial anterior synovectomy, conducted via anteromedial and anterolateral portals. During the five-year follow-up period, no recurrence was observed, and the American Orthopedic Foot and Ankle Score (AOFAS) was assessed as 88.
CLINICAL DISCUSSION
Given the uncommon occurrence of this disease, no standardized treatment approach has been established in the literature. While many researchers advocate for surgical intervention to alleviate symptoms and prevent potential complications like osteoarthritis and malignancy, there exists a diversity of perspectives concerning the specific strategies and techniques to employ.
CONCLUSION
Partial anterior synovectomy and loose body removal using arthroscopy via anteromedial and anterolateral portals demonstrate a notably efficacious and low-risk technique for addressing primary synovial chondromatosis affecting the anterior chamber of the ankle.
PubMed: 37738829
DOI: 10.1016/j.ijscr.2023.108832 -
Journal of Orthopaedic Case Reports Aug 2023The elbow pain and restricted movement is a nagging problem and elbow arthropathies need to be excluded. On rare instances, uncommon etiology like a benign lesion is the...
INTRODUCTION
The elbow pain and restricted movement is a nagging problem and elbow arthropathies need to be excluded. On rare instances, uncommon etiology like a benign lesion is the culprit and the diagnosis would require judicious clinicoradiological correlation. Osteoid osteoma in the intra- or juxta-articular region is reported in the literature as rare, sporadic report.
CASE REPORT
A 23-year-old, Indian male patient presented with a provisional diagnosis of early elbow arthropathy on account of unexplained pain and restricted elbow movement without a history of trauma. He was subjected to appropriate investigations revealing synovial hypertrophy, effusion, and bone edema suggestive of early arthropathy. Additional imaging led to an uncommon definitive diagnosis. An intra-articular osteoid osteoma was found over the medial aspect of the coronoid fossa with a thin rim of cortical rim projecting anteriorly. The lesion was diagnosed and delineated on computerized tomography and an open excision of the lesion and synovectomy was done for histopathological evaluation. Histology confirmed the presence of an osteoid osteoma at an uncommon location.
CONCLUSION
The careful appreciation of radiological images is critical to not miss significant etiology that may mimic non-specific elbow pain. High index of suspicion coupled with appropriate diagnostic imaging results in early diagnosis and appropriate management. Osteoid osteoma should be a differential diagnosis in cases with pain and restricted elbow movement and excision of which results in recovery of painless range of motion.
PubMed: 37654760
DOI: 10.13107/jocr.2023.v13.i08.3842 -
Journal of Orthopaedic Case Reports Aug 2023Synovial chondromatosis is a rare non- malignant bone tumor. Most commonly middle aged people are affected . This condition most commonly occurs in knee joints, and...
INTRODUCTION
Synovial chondromatosis is a rare non- malignant bone tumor. Most commonly middle aged people are affected . This condition most commonly occurs in knee joints, and rarely, it may occur in other joints. Patient usually complaints of pain, swelling and restrictions of movements at the affected joint. Diagnosis is made through thorough clinical examination and Radiological investigation. Condition is treated with open synovectomy with the removal of loose bodies. If not treated in time the patient might develop early osteoarthritic changes and rarely develop into malignancy in few cases.
CASE REPORT
A 43 year old female came with complaints of pain and stiffness over the right elbow which aggravates on movements without alleged history of trauma. The patient was diagnosed with synovial chondromatosis after appropriate radiological investigation. The patient underwent open synovectomy and post operatively adequate physiotherapy was initiated at the operated elbow. After 6 months of follow-up, the patient improved clinically and functionally.
CONCLUSION
Synovial chondromatosis of the elbow is a rare benign orthopedic condition that appears as multiple hyaline cartilage nodules within sub synovial connective tissue. Complete excision of synovium is necessary to prevent the recurrence and for better clinical outcome.
PubMed: 37654745
DOI: 10.13107/jocr.2023.v13.i08.3802 -
Danish Medical Journal Aug 2023In the US, opioids are commonly prescribed after arthroscopic knee surgery. We aimed to investigate opioid dispensing in relation to arthroscopic knee surgeries from...
INTRODUCTION
In the US, opioids are commonly prescribed after arthroscopic knee surgery. We aimed to investigate opioid dispensing in relation to arthroscopic knee surgeries from 2006 to 2018 in Denmark.
METHODS
In Danish registries, we identified patients (≥ 15 years old) having arthroscopic knee surgery (anterior cruciate ligament (ACL) reconstruction; meniscal surgery; cartilage resection; synovectomy and diagnostic arthroscopy) between 1 January 2006 and 31 December 2018 and opioid dispensing (oral morphine equivalents (OMEQ)) within seven days after discharge from surgery.
RESULTS
Among 218,940 patients, 15,263 (7%) had an opioid dispensed within seven days after being discharged following surgery. The opioid dispensing incidence (per 1,000 persons/year) increased during the study period for all procedures. This trend was more pronounced for ACL reconstruction, which recorded an increase from 86 (95% confidence interval (CI): 75-99) in 2006 to 278 (95% CI: 255-301) in 2018, corresponding to 9% and 28% of ACL patients, respectively. In the same period, the average amount of opioids dispensed within the first seven days after discharge decreased (change: 70.0 OMEQ (95% CI: 12.4-127.5)). Tramadol and oxycodone were the most commonly dispensed opioids.
CONCLUSION
About 7% of patients had an opioid dispensed within the first seven days after discharge following arthroscopic knee surgery. The incidence of opioids dispensed increased for all investigated procedures from 2006 to 2018. In the same period, the average amount of opioids dispensed within the first seven days after discharge decreased.
FUNDING
None.
TRIAL REGISTRATION
Not relevant.
Topics: Humans; Adolescent; Analgesics, Opioid; Arthroscopy; Tramadol; Patient Discharge; Denmark
PubMed: 37622647
DOI: No ID Found -
BioRxiv : the Preprint Server For... Aug 2023Temporomandibular Disorders (TMDs) is present in 33% of the U.S. population. Currently available animal models do not faithfully simulate the native disease progression...
Temporomandibular Disorders (TMDs) is present in 33% of the U.S. population. Currently available animal models do not faithfully simulate the native disease progression of TMJ OA. The initiation of TMJ OA requires both local trauma and systemic inflammation. In this study, we present a novel mouse model which reproduces these two conditions. This is achieved by a procedure involving both synovectomy (local trauma) and a distant burn injury (systemic inflammation). Its efficacy at inducing TMJ OA was assessed with histomorphology and radiographic evaluation at 1,3, and 9 weeks after the procedure. We found that burn/synovectomy mice demonstrated significantly more degenerative changes in TMJ than uninjured control mice or synovotomy mice. The observed histology in burn/synoectomy mice mimicked native TMJ OA disease progression in a faithful manner. This animal model is invaluable in future research of the mechanism and risk factors of TMJ OA.
PubMed: 37609135
DOI: 10.1101/2023.08.07.552340 -
International Journal of Surgery Case... Sep 2023TGCT (tenosynovial giant cell tumor) is a mono-articular proliferative condition that begins in the synovial membranes. Diffuse TGCT (DTGCT) has more prominent symptoms...
INTRODUCTION
TGCT (tenosynovial giant cell tumor) is a mono-articular proliferative condition that begins in the synovial membranes. Diffuse TGCT (DTGCT) has more prominent symptoms with high risks of recurrency.
CASE PRESENTATION
In this case, we presented a 32-year-old male with recurrent case of DTGCT. The patient has been treated with arthroscopic synovectomy with the recurrence of disease. The patient was finally treated by open synovectomy combined with arthroscopy followed by adjuvant radiotherapy.
DISCUSSION
The aim of this case is to report the success of open synovectomy combined with arthroscopy followed by 31 cycle of adjuvant radiotherapy in the recurrent case of DTGCT.
CONCLUSION
Open synovectomy combined with arthroscopic synovectomy followed by adjuvant RT is a promising treatment modality in patient with DTGCT.
PubMed: 37591190
DOI: 10.1016/j.ijscr.2023.108604 -
International Journal of Surgery Case... Sep 2023Patellar tendon ossification is a rare complication that primarily occurs following a knee injury. This article aims to describe, for the first time, a case of patellar...
INTRODUCTION
Patellar tendon ossification is a rare complication that primarily occurs following a knee injury. This article aims to describe, for the first time, a case of patellar tendon ossification following synovectomy.
CASE PRESENTATION
A 48-year-old male with a diagnosis of rheumatoid arthritis presented with swelling in his left knee following a synovectomy procedure. After a thorough physical examination, radiographic assessment, and computed tomography, the patient was diagnosed with total patellar tendon ossification. Subsequently, the patient underwent excision of the ossified mass and tendon reconstruction using an Achilles allograft.
DISCUSSION
The primary causes of patellar tendon ossification are iatrogenic and traumatic injuries. The presence of rheumatoid arthritis, which negatively affects tissue healing, may exacerbate this condition. Smaller lesions can be managed conservatively or through resection and repair. In cases of extensive ossification, resection and reconstruction are necessary. A comprehensive literature review is also provided.
CONCLUSION
The occurrence of patellar tendon swelling following trauma or surgery should raise suspicion of patellar tendon ossification. Rheumatoid arthritis is a risk factor for the development of patellar tendon ossification. In cases of extensive ossification, successful treatment can be achieved through reconstruction using an Achilles allograft.
PubMed: 37574628
DOI: 10.1016/j.ijscr.2023.108574 -
Annals of Medicine and Surgery (2012) Aug 2023Synovial chondromatosis is a rare condition characterized by the chondral proliferation of synovium forming loose bodies which can lead to pain, swelling, and decreased...
UNLABELLED
Synovial chondromatosis is a rare condition characterized by the chondral proliferation of synovium forming loose bodies which can lead to pain, swelling, and decreased range of movement of the affected joint.
CASE PRESENTATION
Here the authors report a case of eighteen years lady with recurrent hip synovial chondromatosis who was treated previously with hip arthrotomy and loose bodies removal and now she underwent arthroscopic loose bodies removal with partial synovectomy.
CLINICAL DISCUSSION
In comparison to arthrotomy of the hip, arthroscopic management is a minimally invasive surgery that is associated with decreased postoperative pain, earlier improvement in range of motion, a shorter course of rehabilitation, and overall lower morbidity.
CONCLUSION
Thus, the authors recommend arthroscopic removal of the loose bodies and partial synovectomy for the management of synovial chondromatosis of the hip.
PubMed: 37554870
DOI: 10.1097/MS9.0000000000000999 -
Antibiotics (Basel, Switzerland) Jul 2023Synovitis, like that associated with chronic bacterial arthritis, is a very rare finding during the implantation of knee endoprostheses. In such cases, we fix the knee...
BACKGROUND
Synovitis, like that associated with chronic bacterial arthritis, is a very rare finding during the implantation of knee endoprostheses. In such cases, we fix the knee prostheses with cement containing two antibiotics and carry out a course of systemic antibiotic administration. The aim was to analyze these cases for incidence, detection of bacteria, risk factors, and outcome.
METHODS
Out of 7534 knee replacements between January 2013 and December 2020, 25 cases were suspected during the surgical procedure to have suffered from bacterial arthritis and were treated accordingly. Total synovectomy was carried out, whereby five intraoperative synovial samples were examined bacteriologically, and the complete synovitis was analyzed histologically. The mean follow-up was 65.3 ± 27.1 (24-85) months.
RESULTS
In nine cases (0.12%), the diagnosis of bacterial arthritis was made histologically and by clinical chemistry (elevated CRP), and in two of these cases, pathogen verification was performed. Eight of these nine patients had previously had injections or surgery associated with the corresponding knee joint or had an underlying immunomodulatory disease. None of the patients developed a periprosthetic infection at a later stage.
CONCLUSION
With an incidence of 0.12%, it is rare to unexpectedly detect bacterial synovitis during surgery. Total synovectomy, use of bone cement with two antibiotics, and immediate systemic antibiotic therapy seem to keep the risk of periprosthetic infection low.
PubMed: 37508249
DOI: 10.3390/antibiotics12071153