Wahab Hussain, Hasan Obada, Habib Ahmed, Baloch Naveed
Department of Orthopaedics, Aga Khan University Hospital AKUH, Karachi, Pakistan.
Ann Med Surg (Lond). 2018 Dec 5;37:25-29. doi: 10.1016/j.amsu.2018.11.016. eCollection 2019 Jan.
Synovial chondromatosis is a benign mono-articular arthropathy affecting synovial joints. It mostly affects knee joint, followed by hip, elbow and wrist and is rarely reported for shoulder joint. The exact pathogenesis is not known. Usual symptoms are pain, difficulty in movement due to mechanical obstruction. The classic treatment is arthrotomy, removal of chondromatoid loose bodies and synovectomy. With recent advances arthroscopic removal of the chondromatoid loose bodies is a good option with relatively better post op rehabilitation and faster recovery.
20 years old gentleman presented to clinic with history of pain in right shoulder for 2 years and decreased range of motion. There was no history of trauma or fever. Work up done and diagnosed with synovial chondromatosis. Arthroscopic removal of chondromatoid loose bodies and synovectomy was done. More than 120 loose bodies were removed. On two (2) years follow-up patient is pain free and having full range of motion at right shoulder joint.
Synovial chondromatosis is rare in shoulder joint. The Primary synovial chondromatosis of unknown etiology, and secondary synovial chondromatosis due to degenerative joint disease. Classic treatment is arthrotomy and synovectomy. With recent advances, arthroscopic removal of loose bodies and synovectomy is also a good option for its treatment. In literature only few cases have been reported treated with arthroscopic removal of loose bodies and synovectomy.
Arthroscopic treatment of synovial chondromatosis is a good option if expertise is available. It causes less surgical trauma, better visualization during surgery, early recovery.
滑膜软骨瘤病是一种影响滑膜关节的良性单关节病。它主要累及膝关节,其次是髋关节、肘关节和腕关节,很少累及肩关节。确切的发病机制尚不清楚。常见症状为疼痛,因机械性阻塞导致活动困难。经典治疗方法是关节切开术、切除软骨瘤样游离体和滑膜切除术。随着最近的进展,关节镜下切除软骨瘤样游离体是一个很好的选择,术后康复相对较好且恢复较快。
一名20岁男性因右肩部疼痛2年、活动范围减小就诊于诊所。无外伤或发热史。经过检查后诊断为滑膜软骨瘤病。进行了关节镜下切除软骨瘤样游离体和滑膜切除术。切除了120多个游离体。在两年的随访中,患者右肩关节无痛,活动范围正常。
滑膜软骨瘤病在肩关节中较为罕见。原发性滑膜软骨瘤病病因不明,继发性滑膜软骨瘤病由退行性关节病引起。经典治疗方法是关节切开术和滑膜切除术。随着最近的进展,关节镜下切除游离体和滑膜切除术也是其治疗的一个好选择。文献中仅有少数病例报道采用关节镜下切除游离体和滑膜切除术进行治疗。
如果有专业技术,关节镜治疗滑膜软骨瘤病是一个很好的选择。它造成的手术创伤较小,手术中视野更好,恢复较早。