Synovial chondromatosis in a young female knee: diagnostic and therapeutic insights
DOI:
https://doi.org/10.14739/2310-1237.2026.1.345506Keywords:
knee joints, cartilage, synovectomy, hyaline nodulesAbstract
Aim of the study: to present a rare case of synovial chondromatosis involving the knee joint in a young female patient, highlighting its clinical features, diagnostic challenges, pathological findings, and management outcomes, in the context of its recent reclassification as a benign neoplasm.
Materials and methods. A 19-year-old female presented with chronic swelling and pain in the right knee for one year, with increased pain and restricted joint movement over the past two months. Clinical evaluation, fine-needle aspiration cytology, and magnetic resonance imaging were performed. The patient underwent open surgical excision with extensive synovectomy, and the excised specimen was subjected to detailed gross and histopathological analysis.
Results. Magnetic resonance imaging revealed multiple intra-articular cartilaginous nodules within the knee joint, predominantly located around the cruciate ligaments and Hoffa’s fat pad. Gross examination revealed multiple grayish-white nodules, while histopathology demonstrated lobules of hyaline cartilage lined by synovium without atypia, confirming the diagnosis of synovial chondromatosis. Postoperative recovery was uneventful with significant improvement in joint mobility. At the three-month follow-up, the patient achieved full, painless range of motion, and no recurrence was noted clinically or radiologically at six months.
Conclusions. Synovial chondromatosis is a rare benign neoplasm of the synovium that may mimic other intra-articular pathologies. Diagnosis requires a combination of clinical, radiological, and histopathological findings. Complete surgical excision with synovectomy offers excellent functional recovery and minimizes the risk of recurrence. Vigilant long-term follow-up is recommended to monitor for potential malignant transformation.
References
- Janssen A, Odekerken G. L’image du mois. L’ostéochondromatose synoviale [Synovial chondromatosis]. Rev Med Liege. 2023;78(10):5334. doi: https://doi.org/10.1016/B978-2-294-77796-7.00009-2
- Mackenzie H, Gulati V, Tross S. A rare case of a swollen knee due to disseminated synovial chondromatosis: a case report. J Med Case Rep. 2010;4:113. doi: https://doi.org/10.1186/1752-1947-4-113
| 
| 
- Neumann JA, Garrigues GE, Brigman BE, Eward WC. Synovial Chondromatosis. JBJS Rev. 2016;4(5):e2. doi: https://doi.org/10.2106/JBJS.RVW.O.00054
| | - Tekaya AB, Hamdi O, Bellil M, Saidane O, Rouached L, Bouden S, et al. Synovial Chondromatosis of the Shoulder in Rheumatoid Arthritis: A Case Report and Brief Review of the Literature. Curr Rheumatol Rev. 2023;19(3):362-6. doi: https://doi.org/10.2174/1573397118666221011113313
| | - Qi PP, Xu ZW. A case of synovial chondromatosis of the knee with 87 free bodies and review of literature. Eur Rev Med Pharmacol Sci. 2024;28(7):2670-6. doi: https://doi.org/10.26355/eurrev_202404_35895
| | - Liu B, Kim SH, Jang YH, Rhee SM, Yoo JC, Kim SC, et al. Synovial Osteochondromatosis: Clinical Characteristics Unique to the Shoulder. Clin Orthop Surg. 2023;15(1):118-26. doi: https://doi.org/10.4055/cios22078
| | - Agaram NP, Zhang L, Dickson BC, Swanson D, Sung YS, Panicek DM, et al. A molecular study of synovial chondromatosis. Genes Chromosomes Cancer. 2020;59(3):144-51. doi: https://doi.org/10.1002/gcc.22812
| | - Deng X, Liu S, Liu H. Synovial chondromatosis: Novel advances in understanding the pathogenesis and in diagnostic strategies (Review). Mol Med Rep. 2026;33(1):33. doi: https://doi.org/10.3892/mmr.2025.13743
| | - Buddingh EP, Krallman P, Neff JR, Nelson M, Liu J, Bridge JA. Chromosome 6 abnormalities are recurrent in synovial chondromatosis. Cancer Genet Cytogenet. 2003;140(1):18-22. doi: https://doi.org/10.1016/s0165-4608(02)00636-2
| | - Ng VY, Louie P, Punt S, Conrad EU. Malignant Transformation of Synovial Chondromatosis: A Systematic Review. Open Orthop J. 2017;11:517-24. doi: https://doi.org/10.2174/1874325001711010517
| - Milgram JW. Synovial osteochondromatosis: a histopathological study of thirty cases. J Bone Joint Surg Am. 1977;59(6):792-801.
| | - Monestier L, Riva G, Stissi P, Latiff M, Surace MF. Synovial chondromatosis of the foot: Two case reports and literature review. World J Orthop. 2019;10(11):404-15. doi: https://doi.org/10.5312/wjo.v10.i11.404
| | - Jang BG, Huh KH, Kang JH, Kim JE, Yi WJ, Heo MS, et al. Imaging features of synovial chondromatosis of the temporomandibular joint: a report of 34 cases. Clin Radiol. 2021;76(8):627.e1-627.e11. doi: https://doi.org/10.1016/j.crad.2021.02.020
| | - Grace MM, Letonoff EJ. Synovial Chondromatosis: An Unusual Case of Knee Pain and Swelling. Fed Pract. 2018;35(4):45-8
- Destruhaut F, Dubuc A, Bos A, Fabié L, Pomar P, Combadazou JC, et al. Diagnosis of Synovial Chondromatosis of Temporomandibular Joint: Case Report and Literature Review. Healthcare (Basel). 2021;9(5):601. doi: https://doi.org/10.3390/healthcare9050601
| | - Wengle LJ, Hauer TM, Chang JS, Theodoropoulos J. Systematic Arthroscopic Treatment of Synovial Chondromatosis of the Knee. Arthrosc Tech. 2021;10(10):e2265-e2270. doi: https://doi.org/10.1016/j.eats.2021.07.001
| | - Liang ZJ, Liu Y, Danakkrisna VR, Liau ZQ. Surgical Options for Primary Synovial Chondromatosis of the Knee: A Systematic Review. Arthroplast Today. 2025;35:101796. doi: https://doi.org/10.1016/j.artd.2025.101796
| |
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Copyright (c) 2026 Geet Bhuyan, Sandeep Khakhlari, Anushmita Gogoi
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