Difference between revisions of "Synovial chondromatosis"

Synovial chondromatosis
	Diagnosis in short
	; Loose body. H&E stain.
LM	hyaline cartilage +/- lobular surface +/-lacunae with binucleate cells, +/-nuclear atypia (moderate to severe), +/-synovial hyperplasia, bone
LM DDx	chondrosarcoma, osteoarthritis
Site	joints - classically knee or hip
Symptoms	pain
Prognosis	benign
Treatment	removal of loose bodies

Latest revision as of 18:59, 12 September 2016

Synovial chondromatosis is a relative common pathology of the joint. It is also known as synovial osteochondromatosis.

Loose body, loose bodies, rice bodies and joint mice redirect to this page.

General

Benign.
- Malignant transformation rare <5%.^[1]
Classically location: knee.^[1]
- Hip next most common site.
Usually adults.
Prevalence: male > female.

Note:

This is a clinicoradiologic diagnosis.

Gross/radiology

Intraarticular calcifications.
Diffuse involvement of the joint.
+/-Loose bodies in the joint (AKA joint mice).

Image

Synovial chondromatosis. (WC)

www:

SC - gross (rsna.org).

Microscopic

Features:^[1]

Hyaline cartilage +/- lobular surface.
- +/-Lacunae with binucleate cells.
- +/-Nuclear atypia - moderate to severe.^[2]
+/-Synovial hyperplasia - ribbon like tissue with an epithelium that has eosinophilic cytoplasm.
Bone.

DDx:

Images

LB - low mag.
LB - intermed. mag.
LB - high mag.
LB - very high mag.
LB - intermed. mag.
LB - high mag.
LB - very high mag.

www:

Sign out

Synovium, Left Knee, Biopsy:
     - Synovium with mild chronic inflammation.
     - Cartilage with ossification, compatible with loose bodies/rice bodies.
     - NEGATIVE for evidence of malignancy.

Block letters

LOOSE BODIES, RIGHT ELBOW, REMOVAL:
- FRAGMENTS OF BONE WITH CARTILAGE AND SYNOVIAL TISSUE COMPATIBLE WITH LOOSE BODIES.

TISSUE, CAPSULE LEFT ELBOW, REMOVAL:
- DEGENERATIVE JOINT DISEASE.
- SYNOVIAL HYPERPLASIA WITHOUT SIGNIFICANT INFLAMMATION.
- ROUND BODIES CONSISTING OF BENIGN BONE WITH A FATTY MARROW, AND FIBROUS
  AND CARTILAGINOUS SURFACE, COMPATIBLE WITH LOOSE BODIES.
- NEGATIVE FOR MALIGNANCY.

LOOSE BODY, LEFT KNEE, REMOVAL:
- BENIGN BONE WITH FIBROTIC SYNOVIAL MEMBRANE, CONSISTENT WITH LOOSE BODY.

Micro

The sections show multiple fragments of tissue consisting of bone covered by hyaline cartilage and associated with synovial hyperplasia.

There is no appreciable nuclear atypia or mitotic activity.

References

↑ ^1.0 ^1.1 ^1.2 Murphey, MD.; Vidal, JA.; Fanburg-Smith, JC.; Gajewski, DA.. "Imaging of synovial chondromatosis with radiologic-pathologic correlation.". Radiographics 27 (5): 1465-88. doi:10.1148/rg.275075116. PMID 17848703.
↑ URL: http://www.webpathology.com/image.asp?n=3&Case=369. Accessed on: 10 December 2012.

[pmid17848703-1] 1.0 ^1.1 ^1.2 Murphey, MD.; Vidal, JA.; Fanburg-Smith, JC.; Gajewski, DA.. "Imaging of synovial chondromatosis with radiologic-pathologic correlation.". Radiographics 27 (5): 1465-88. doi:10.1148/rg.275075116. PMID 17848703.

[2] URL: http://www.webpathology.com/image.asp?n=3&Case=369. Accessed on: 10 December 2012.

[1]

[2]

@@ Line 1: / Line 1: @@
-#redirect [[Cartilage#Synovial_chondromatosis]]
+{{ Infobox diagnosis
+| Name       = {{PAGENAME}}
+| Image      = Loose body -- intermed mag.jpg
+| Width      =
+| Caption    = Loose body. [[H&E stain]].
+| Synonyms   =
+| Micro      = [[hyaline cartilage]] +/- lobular surface +/-lacunae with binucleate cells, +/-nuclear atypia (moderate to severe), +/-synovial hyperplasia, [[bone]]
+| Subtypes   =
+| LMDDx      = [[chondrosarcoma]], [[osteoarthritis]]
+| Stains     =
+| IHC        =
+| EM         =
+| Molecular  =
+| IF         =
+| Gross      =
+| Grossing   =
+| Site       = [[joints]] - classically knee or hip
+| Assdx      =
+| Syndromes  =
+| Clinicalhx =
+| Signs      =
+| Symptoms   = pain
+| Prevalence =
+| Bloodwork  =
+| Rads       =
+| Endoscopy  =
+| Prognosis  = benign
+| Other      =
+| ClinDDx    =
+| Tx         = removal of loose bodies
+}}
+'''Synovial chondromatosis''' is a relative common pathology of the [[joint]]. It is also known as '''synovial osteochondromatosis'''.
+'''Loose body''', '''loose bodies''', '''rice bodies''' and '''joint mice''' redirect to this page.
+==General==
+*Benign.
+**Malignant transformation rare <5%.<ref name=pmid17848703/>
+*Classically location: knee.<ref name=pmid17848703>{{Cite journal  | last1 = Murphey | first1 = MD. | last2 = Vidal | first2 = JA. | last3 = Fanburg-Smith | first3 = JC. | last4 = Gajewski | first4 = DA. | title = Imaging of synovial chondromatosis with radiologic-pathologic correlation. | journal = Radiographics | volume = 27 | issue = 5 | pages = 1465-88 | month =  | year =  | doi = 10.1148/rg.275075116 | PMID = 17848703 | URL = http://radiographics.rsna.org/content/27/5/1465.long }}</ref>
+**Hip next most common site.
+*Usually adults.
+*Prevalence: male > female.
+Note:
+*This is a clinicoradiologic diagnosis.
+==Gross/radiology==
+*Intraarticular calcifications.
+*Diffuse involvement of the joint.
+*+/-Loose bodies in the joint ([[AKA]] ''joint mice'').
+===Image===
+<gallery>
+Image:ChondromatoseCoude.jpg | Synovial chondromatosis. (WC)
+</gallery>
+www:
+*[http://radiographics.rsna.org/content/27/5/1465/F26.expansion.html SC - gross (rsna.org)].
+==Microscopic==
+Features:<ref name=pmid17848703/>
+*[[Hyaline cartilage]] +/- lobular surface.
+**+/-Lacunae with binucleate cells.
+**+/-Nuclear atypia - moderate to severe.<ref>URL: [http://www.webpathology.com/image.asp?n=3&Case=369 http://www.webpathology.com/image.asp?n=3&Case=369]. Accessed on: 10 December 2012.</ref>
+*+/-Synovial hyperplasia - ribbon like tissue with an epithelium that has eosinophilic cytoplasm.
+*[[Bone]].
+DDx:
+*[[Chondrosarcoma]].
+*[[Osteoarthritis]].
+===Images===
+<gallery>
+Image: Loose body -- low mag.jpg | LB - low mag.
+Image: Loose body -- intermed mag.jpg | LB - intermed. mag.
+Image: Loose body -- high mag.jpg | LB - high mag.
+Image: Loose body -- very high mag.jpg | LB - very high mag.
+Image: Loose body - alt -- intermed mag.jpg | LB - intermed. mag.
+Image: Loose body - alt -- high mag.jpg | LB - high mag.
+Image: Loose body - alt -- very high mag.jpg | LB - very high mag.
+</gallery>
+www:
+*[http://radiographics.rsna.org/content/27/5/1465.long Synovial chondromatosis (rsna.org)].
+*[http://radiographics.rsna.org/content/27/5/1465/F45.expansion.html Synovial chondromatosis - low mag. (rsna.org)].
+*[http://www.webpathology.com/image.asp?n=1&Case=369 Synovial chondromatosis (webpathology.com)].
+*[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3051128/figure/F0006/ Loose body with fibrotic synovial membrane (nih.gov)].
+==Sign out==
+<pre>
+Synovium, Left Knee, Biopsy:
+     - Synovium with mild chronic inflammation.
+     - Cartilage with ossification, compatible with loose bodies/rice bodies.
+     - NEGATIVE for evidence of malignancy.
+</pre>
+===Block letters===
+<pre>
+LOOSE BODIES, RIGHT ELBOW, REMOVAL:
+- FRAGMENTS OF BONE WITH CARTILAGE AND SYNOVIAL TISSUE COMPATIBLE WITH LOOSE BODIES.
+</pre>
+<pre>
+TISSUE, CAPSULE LEFT ELBOW, REMOVAL:
+- DEGENERATIVE JOINT DISEASE.
+- SYNOVIAL HYPERPLASIA WITHOUT SIGNIFICANT INFLAMMATION.
+- ROUND BODIES CONSISTING OF BENIGN BONE WITH A FATTY MARROW, AND FIBROUS
+  AND CARTILAGINOUS SURFACE, COMPATIBLE WITH LOOSE BODIES.
+- NEGATIVE FOR MALIGNANCY.
+</pre>
+<pre>
+LOOSE BODY, LEFT KNEE, REMOVAL:
+- BENIGN BONE WITH FIBROTIC SYNOVIAL MEMBRANE, CONSISTENT WITH LOOSE BODY.
+</pre>
+====Micro====
+The sections show multiple fragments of tissue consisting of bone covered by hyaline cartilage and associated with synovial hyperplasia.
+There is no appreciable nuclear atypia or mitotic activity.
+==See also==
+*[[Cartilage]].
+*[[Bone]].
+*[[Osteophyte]].
+==References==
+{{Reflist|2}}
 [[Category:Diagnosis]]