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Hip joint destruction and secondary synovial chondromatosis in a patient with rheumatoid arthritis


Authors: L. Šedová 1;  C. Povýšil 2;  Z. Urbanová 1;  O. Kryštůfková 1;  J. Gatterová 1;  P. Dupal 3;  K. Pavelka 1
Authors‘ workplace: Revmatologický ústav Praha, 2Ústav patologie 1. LF UK a VFN, 3I. ortopedická klinika VFN Motol 1
Published in: Čes. Revmatol., 15, 2007, No. 4, p. 201-204.
Category: Case Report

Overview

Synovial chondromatosis is a rare disease of unknown etiology, which arises from hyaline metaplastic transformation of synovial membrane. It is mostly monoarticular and affects large joints of lower extremities. Clinical picture and radiographic findings are indistinguishable from rapidly progressive osteoarthritis at the onset of the disease. In the late course, destruction of joint and bone structures is observed. Presented case report demonstrates difficulties of differential diagnosis in a patient with rheumatoid arthritis in whom the presence of synovial chondromatosis resembled malignant process of joint or pelvis that was resolved by radical surgery firstly by extirpation and subsequently by total hip implants.

Key words:
Synovial chondromatosis, hyaline metaplasia, rheumatoid arthritis


Sources

1. Schajowier F. Tumors and tumorlike lesions of bone and joints. Springer-Verlag New York, 1981.

2. Chen A, Wong LY, Sheu CY, Chen BF. Distinguishing multiple rice body formation in chronic subacromial-subdeltoid bursitis from synovial chondromatosis. Skeletal Radiol 2002; 31: 119-21.

3. Milgram JW. Synovial osteochondromatosis. A histopathological study of thirty cases. J Bone Surg Am 1977; 59: 792-801.

4. Milgram JW, Addison RG. Synovial osteochondromatosis of the knee. J Bone Surg Am 1976; 58: 264-6.

5. Arnett FC, Edworthy SM, Bloch DA, et al. The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum 1988; 31: 315-24.

6. Steinbrocker O, Traeger CH, Batterman RC. Therapeutic kriteria in rheumatoid arthritis. J Am Med J 1949; 140: 659-62.

Labels
Dermatology & STDs Paediatric rheumatology Rheumatology
Topics Journals
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