Synovial chondromatosis

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Synovial chondromatosis is a disease affecting the synovium, a thin flexible membrane around a joint.

[edit] Symptoms

Patients usually complain of pain in one joint, which persists or months, or even years, does not ease with exercise, steroid injection or heat treatment, shows nothing on X-ray, but shows a definite restriction of movement.

In the early stages of the disease, is often confused with tendonitis and/or arthritis.

In the disease, the thin flexible membrane of the synovium gradually thickens and becomes less flexible, eventually turning into cartlidge. Particles can break free inside the joint forming nodules as small as pinheads or as large as butterbeans – these add to the discomfort and stiffness of the joint.

This cartilage does not show up using conventional x-rays, the joint appearing substantially healthy (although it will have become extremely stiff and frequently painful)

This is an extremely rare condition; as a result, diagnosis is typically takes around six years and is often by a process of elimination. The affected tissue will show up as a semi-solid mass in an NMR scan, final diagnosis is usually confirmed by taking a biopsy.

People suffering from this disease are nearly always (but not exclusively) male, and in their forties. The disease usually affects only one of the larger weight beading joints (hip, ankle, knee) – although the elbow, and wrist can be affected.

[edit] Treatment

Treatment is frequently by means of a partial or full Synovectomy (removal of the synovium) – this is a moderately major operation and involves completely exposing the joint and removing the affected tissue. Partial synovectomy can be done arthroscopically.

In 75% of cases, healthy tissue spontaneously grows in its place, in the remaining one on four cases, the ‘wrong’ tissue appears. The process CAN be repeated, the chances of successes are not reduced, however as with any serious orthopaedic operation, there is a risk of doing more harm than good.

Whilst the condition can be described as a ‘benign growth’ it seldom affects more than one joint, and does not usually affect surrounding tissue.