Phalak Mukesh, Nair Abhishek, Reddy Rajeev, Chopra Shubhankar, Kumar Sushant
Orthopaedics, Dr. D.Y Patil Medical College, Hospital and Research Centre, Dr. D.Y. Patil Vidyapeeth (Deemed to be University), Pune, IND.
Cureus. 2024 Aug 28;16(8):e68072. doi: 10.7759/cureus.68072. eCollection 2024 Aug.
Synovial chondromatosis is a rare condition that is also known as Reichel syndrome. It is a disorder that affects the monoarticular joints. The proliferation and metaplasia of the synovial cartilage are its defining characteristics. Many tiny, intra-articular osseocartilaginous loose bodies are formed as a result of this proliferation. They are fed by the synovial fluid once they break off from the synovial surface and enter the joint cavity, where they develop into calcification and ossification. If left untreated, it usually causes the afflicted joint to malfunction severely. Large joints such as the knee, hip, elbow, and shoulder joints are frequently the sites of nodular proliferation. Smaller joints such as the hand's interphalangeal and metacarpal joints and thumb are among the more unusual locations. Although the disease usually resolves on its own, conservative management options include painkillers, activity modification, and cryotherapy. Surgical options include synovectomy, which is the gold standard procedure and involves removing the loose bodies. The following case study presents a 60-year-old female patient with a rare instance of synovial chondromatosis. She presented to the outpatient department (OPD) due to escalating pain and swelling in the proximal interphalangeal (PIP) joint of her right index finger, which significantly restricted her range of motion. On the hand X-ray, several small, uniformly sized calcified bodies were visible within the synovium. After negative results from autoimmune disease tests, the patient was recommended for surgical exploration as the patient reported a six-month increase in pain and difficulty flexing his index finger. Surgical exploration of the PIP joint and adjacent proximal and middle phalanx revealed several small, evenly sized, firm, smooth, creamy-white nodules. Post-op, the patient was given a splint cast for a span of seven days, followed by physical therapy, and the range of motion was achieved by the end of six months.
滑膜软骨瘤病是一种罕见病症,也被称为赖歇尔综合征。它是一种影响单关节的疾病。滑膜软骨的增殖和化生是其主要特征。这种增殖会形成许多微小的关节内骨软骨游离体。它们从滑膜表面脱落进入关节腔后,由滑液滋养,在关节腔内发展为钙化和骨化。若不治疗,通常会导致患病关节严重功能障碍。诸如膝关节、髋关节、肘关节和肩关节等大关节常是结节性增殖的部位。手部指间关节、掌指关节和拇指等较小关节则是较为少见的发病部位。尽管该病通常可自行缓解,但保守治疗方法包括使用止痛药、调整活动以及冷冻疗法。手术治疗方法包括滑膜切除术,这是金标准手术,即切除游离体。以下病例研究介绍了一名60岁女性患者,她患有罕见的滑膜软骨瘤病。她因右手食指近端指间关节疼痛和肿胀加剧而前来门诊就诊,这严重限制了她的活动范围。手部X线检查显示,滑膜内可见几个大小均匀的小钙化体。自身免疫性疾病检测结果为阴性后,鉴于患者报告疼痛增加了六个月且食指弯曲困难,建议对其进行手术探查。对近端指间关节及相邻的近端和中间指骨进行手术探查时,发现了几个大小均匀、质地坚硬、表面光滑的乳白色小结节。术后,患者佩戴夹板石膏固定七天,随后接受物理治疗,六个月结束时恢复了活动范围。