RESUMEN
BACKGROUND: Arthroscopic treatment is recommended for hip synovial chondromatosis. However, evidence regarding long-term clinical outcomes is limited. PURPOSE: To evaluate long-term patient-reported outcomes (PROs) and survival, and to determine the potential effect of residual loose bodies, as evaluated by immediate postoperative computed tomography (CT), on clinical outcomes. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: A consecutive cohort of patients undergoing arthroscopic treatment and diagnosed with synovial chondromatosis between March 2010 and May 2015 were included in the study. Preoperative radiography, CT, and magnetic resonance imaging were performed. Preoperative, midterm (minimum of 4 years), and long-term (minimum of 8 years) PROs were collected for visual analog scale for pain, modified Harris Hip Score (mHHS), Non-Arthritic Hip Score (NAHS), and 12-item international Hip Outcome Tool (iHOT-12). The percentages achieving minimal clinically important difference (MCID) were calculated. PROs and survival were compared between patients with and without residual loose bodies evident on immediate postoperative CT scan. RESULTS: A total of 28 patients (20% of patients were lost to follow-up) were included in the study with a mean follow-up period of 104.9 months (range, 96-139 months). PROs including visual analog scale for pain (preoperative, 3.8 ± 1.2; midterm, 0.9 ± 1.7; long-term, 0.8 ± 1.4), mHHS (preoperative, 66.4 ± 14.4; midterm, 92.8 ± 12.3; long-term, 93.5 ± 10.5), NAHS (preoperative, 45.2 ± 16.2; midterm, 81.8 ± 15.3; long-term, 83.1 ± 12.9), and iHOT-12 (preoperative, 48.4 ± 15.6; midterm, 69.3 ± 11.7; long-term, 72.7 ± 11.4) were improved at both midterm and long-term follow-up (all with P < .001). In total, 27 (96.4%), 28 (100%), and 26 (92.9%) patients achieved MCID for mHHS, NAHS and iHOT-12, respectively, at the long-term follow-up. No significant difference was found in any of the PROs and the rate of achieving MCID between midterm and long-term follow-up (all with P > .05). One patient (3.6%) underwent revision surgery. Among the 23 patients who had loose bodies on preoperative CT or radiographs, 14 patients (60.9%) with residual loose bodies evident on immediate postoperative CT demonstrated lower NAHS (P = .045) and iHOT-12 (P = .037) scores but a comparable survival (P > .05) at long-term follow-up compared with those who did not have loose bodies. CONCLUSION: Arthroscopic treatment for hip synovial chondromatosis achieved satisfactory long-term clinical outcomes with strong survival. Most patients maintained or improved their overall functional status between midterm and long-term follow-up. Furthermore, patients with residual loose bodies had less favorable clinical outcomes, although the survival rate was comparable.
Asunto(s)
Artroscopía , Condromatosis Sinovial , Articulación de la Cadera , Medición de Resultados Informados por el Paciente , Humanos , Femenino , Masculino , Persona de Mediana Edad , Adulto , Condromatosis Sinovial/cirugía , Condromatosis Sinovial/diagnóstico por imagen , Estudios de Seguimiento , Articulación de la Cadera/cirugía , Articulación de la Cadera/diagnóstico por imagen , Cuerpos Libres Articulares/cirugía , Cuerpos Libres Articulares/diagnóstico por imagen , Tomografía Computarizada por Rayos X , Estudios Longitudinales , Resultado del Tratamiento , Anciano , Imagen por Resonancia Magnética , Dimensión del DolorRESUMEN
abstract: Primary synovial chondromatosis of the hip is a rare joint condition characterized by the abnormal proliferation of cartilaginous tissue within the synovial membrane, which leads to the formation of clusters of chondrocytes floating in the joint space. This commentary provides a comprehensive overview of the pathology, including symptoms, diagnosis, treatment options and long-term management. Patients with primary synovial chondromatosis complaint pain and functional impairment, together with a peculiar joint popping sensation during movement, so determining early disability. The early treatment can lead to better clinical outcomes, with increased preservation of joint function and reduced risk of long-term disability, but strictly depend on symptoms acknowledgement and proper imaging interpretation. As a chronic pathology, surgical approach must necessarily be part of a larger medical and rehabilitative care planning, with long period follow-up. Multidisciplinary team management, with the active involvement of the patient is pivotal in improving the clinical outcomes and quality of life.
Asunto(s)
Condromatosis Sinovial , Articulación de la Cadera , Modalidades de Fisioterapia , Humanos , Condromatosis Sinovial/cirugía , Condromatosis Sinovial/diagnóstico por imagenRESUMEN
PURPOSE: To report the surgical outcome of synovial osteochondromatosis, a rare tumor of the cervical spine, in a 6-year-old boy. METHODS: A 6-year-old boy presented with muscle weakness in the right deltoid (2) and biceps (4) during a manual muscle test. Magnetic resonance imaging showed a 3 × 2 × 1.5 cm mass within the spinal canal at the C4-6 level, compressing the cervical spinal cord from the right side. Computed tomography revealed hyperintense areas within the tumor and ballooning of the right C4-5 and C5-6 facet joints. RESULTS: After a biopsy confirmed the absence of malignancy, a gross total resection was performed. The pathological diagnosis of synovial osteochondromatosis was established. Postoperatively, muscle weakness improved fully in the manual muscle test, and there were no neurological findings after 3 months. However, the patient is under careful follow-up owing to the detection of a regrowth site within the right C4-5 and C5-6 intervertebral foramen 2 years postoperatively. CONCLUSIONS: Synovial osteochondromatosis of the cervical spine in children is rare, and this is the first report of its regrowth after surgery. Synovial osteochondromatosis should be included in the differential diagnosis of pediatric cervical spine tumors.
Asunto(s)
Vértebras Cervicales , Condromatosis Sinovial , Laminectomía , Humanos , Masculino , Niño , Vértebras Cervicales/cirugía , Vértebras Cervicales/diagnóstico por imagen , Laminectomía/métodos , Condromatosis Sinovial/cirugía , Condromatosis Sinovial/diagnóstico por imagen , Parálisis/etiología , Parálisis/cirugía , Resultado del Tratamiento , Recuperación de la Función , Compresión de la Médula Espinal/cirugía , Compresión de la Médula Espinal/etiología , Compresión de la Médula Espinal/diagnóstico por imagen , Imagen por Resonancia MagnéticaRESUMEN
BACKGROUND: Synovial chondromatosis is a non-malignant synovial disorder characterized by the presence of cartilage formation within the synovial membrane, leading to the emergence of multiple cartilaginous nodules that may be either attached or unattached. The presence of this anatomical feature is frequently observed in articulations such as the knee, hip, elbow, and ankle. CASE REPORT: In this study, we present a case of synovial chondromatosis in the knee joint of a healthy male in his early 60s. Notably, the patient exhibited the simultaneous presence of 87 large loose bodies. The occurrence of a substantial quantity of unattached entities of notable dimensions within the joint is highly uncommon. CONCLUSIONS: The patient had several synovial chondromas, a rare disease. Synovial chondromatosis is a benign disorder; however, growing synovium can cause pyogenic cartilage nodules. Most loose bodies in joints can abrade and degenerate articular cartilage, causing long-term discomfort. Thus, an early-stage procedure to remove loose bodies and carefully excise synovial tissue is necessary to treat this condition.
Asunto(s)
Cartílago Articular , Condromatosis Sinovial , Humanos , Masculino , Articulación del Tobillo , Cartílago Articular/patología , Condromatosis Sinovial/diagnóstico por imagen , Condromatosis Sinovial/cirugía , Condromatosis Sinovial/patología , Articulación de la Rodilla/diagnóstico por imagen , Articulación de la Rodilla/cirugía , Articulación de la Rodilla/patología , Membrana Sinovial/patología , Persona de Mediana EdadRESUMEN
OBJECTIVE: Herein, we aimed to study the clinical, radiographical, and histopathologic features of synovial chondromatosis in the temporomandibular joint (SC in TMJ) and provide references for early diagnosis and treatment prognosis. STUDY DESIGN: The medical records and imaging examinations of patients with SC in TMJ, diagnosed using postoperative histopathologic examination, were reviewed and analyzed. Among them, 18 cases who lacked calcified loose bodies on spiral computed tomography or cone beam computed tomography (SCT/CBCT) were selected for further study. Descriptive statistical methods were used to analyze the clinical characteristics of patients. RESULTS: The study included 100 patients with SC in TMJ, who were predominantly female (male to female: 1:3), and were aged from 21 to 77 years (median, 47). Radiopaque calcified lesions on SCT/CBCT were missing in 18 cases, but cartilaginous nodules were observed during surgery. The cases lacking calcification had a relatively shorter disease course, suggesting they were in the early stages of SC. CONCLUSION: In the early stage of SC, although calcified loose bodies cannot be detected on SCT/CBCT, attention should be paid to the widening of the posterior superior joint space and sclerosis or slight erosion of the joint fossa. Magnetic resonance imaging would be helpful to detect the early-stage SC in TMJ.
Asunto(s)
Condromatosis Sinovial , Humanos , Femenino , Masculino , Condromatosis Sinovial/diagnóstico por imagen , Condromatosis Sinovial/cirugía , Estudios Retrospectivos , Articulación Temporomandibular/diagnóstico por imagen , Tomografía Computarizada por Rayos X , Progresión de la EnfermedadRESUMEN
La osteocondromatosis sinovial es una metaplasia benigna de la membrana sinovial que afecta a 1 de cada 100 000 personas, en su mayoría adultos, y es extremadamente infrecuente en edad pediátrica. Predomina en grandes articulaciones, sobre todo la rodilla, y la sintomatología es, por lo general, inespecífica. Dado que la radiografía simple no suele ser concluyente, se recurre a la resonancia magnética nuclear y a la tomografía axial computarizada para orientar el diagnóstico. Se expone el caso de una paciente de 10 años de edad con gonalgia y dismorfia en la patela izquierda de seis meses de evolución, con diagnóstico de osteocondromatosis sinovial. Se presenta el caso dado que se trata de una entidad muy rara en niños, pero que requiere un tratamiento quirúrgico precoz para evitar sus posibles complicaciones, como la destrucción articular progresiva o la malignización a condrosarcoma.
Synovial osteochondromatosis consists of a synovial metaplasia which affects 1 per 100 000 people. It is a very rare disease among children. It typically affects large joints of the body, especially the knee. Due to the lack of specificity of the signs and symptoms and X-Ray images, imaging tests such as nuclear magnetic resonance or computerized tomography are frequently needed for diagnosis.We report a case of a ten-year-old female patient with a six months history of pain and deformity of left patella which was diagnosed with synovial osteochondromatosis. This case highlights the importance of clinical suspicion, not only because it is an extremely rare disease in children, but also because it needs a surgical treatment as soon as possible in order to avoid consequences it might have in pediatric age, as joint destruction or malignization to chondrosarcoma.
Asunto(s)
Humanos , Femenino , Niño , Condromatosis Sinovial/cirugía , Condromatosis Sinovial/diagnóstico por imagen , Condromatosis Sinovial/terapia , Condrosarcoma/prevención & control , Articulación de la Rodilla/anomalías , MetaplasiaRESUMEN
RESUMEN: La condromatosis sinovial (CS), es una lesión benigna poco frecuente y de clínica bastante inespecífica. Suele afectar articulaciones de huesos largos como la rodilla, el codo y la cadera, presentándose generalmente de manera unilateral. Se cree que solo un 3 % de los casos de CS afecta la articulación temporomandibular. Esta condición se caracteriza por ser un trastorno metaplásico del tejido conectivo sinovial que suele manifestarse con la formación de pequeños y múltiples nódulos de cartílago que posteriormente pueden desprenderse, calcificarse y formar cuerpos libres dentro del espacio articular. Presentamos el caso de una mujer de 55 años con condromatosis sinovial de la articulación temporomandibular, tratada desde hace 3 años bajo el diagnóstico de desórdenes temporomandibulares. A pesar de ser considerada una lesión de tipo benigna, esta puede llegar a ser localmente agresiva, extendiéndose como en nuestro reporte hacia la fosa craneal media, adelgazando parte del hueso temporal.
ABSTRACT: Synovial chondromatosis (CS) is a benign lesion that is rare and clinically quite nonspecific. It usually affects the joints of long bones such as the knee, elbow and hip, usually occurring unilaterally. It is believed that in only 3 % of cases of CS the temporomandibular joint. This is a condition its characterized by being a metaplastic synovial connective tissue that manifests itself with the formation of small and multiple cartridges that detach, calcify and form free bodies within the joint space. We present the case of a 55-year-old woman with synovial chondromatosis of the temporomandibular joint, treated for 3 years under the diagnosis of temporomandibular disorders. Despite being considered a benign lesion, this can become locally aggressive, extending as in our report to the cranial fossa, thinning part of the temporal bone.
Asunto(s)
Humanos , Femenino , Persona de Mediana Edad , Hueso Temporal/patología , Trastornos de la Articulación Temporomandibular/patología , Condromatosis Sinovial/cirugía , Condromatosis Sinovial/patología , Hueso Temporal/cirugía , Calcinosis/etiología , Imagen por Resonancia Magnética , Trastornos de la Articulación Temporomandibular/cirugía , Condromatosis Sinovial/complicaciones , Tomografía Computarizada de Haz CónicoRESUMEN
Abstract Synovial chondromatosis is a rare condition characterized by benign chondrogenic metaplasia of extra-articular synovial tissue. It usually affects a single tendon sheath of the hand or foot. This report describes a rare case with extensive synovial chondromatosis affecting all flexor tendons in the tarsal tunnel, its radiological features, surgical treatment, and clinical outcome. The authors present a unique case of extensive synovial chondromatosis in a 48-year-old male involving the tendon sheaths of the flexor hallucis longus, flexor digitorum longus, and posterior tibialis tendons, at the level of the tarsal tunnel, with extension into the plantar aspect of the foot. The patient initially presentedwith symptoms of tarsal tunnel compression and was found to have a 4-cm mass in the posteromedial aspect of the ankle. The presumptive diagnosis of synovial chondromatosiswasmadebased on radiographic and magnetic resonance imaging evidence. The patient underwent surgical resection of the tumor, aswell as tarsal tunnel releaseandgastrocnemius recession. The diagnosiswas confirmed postoperatively by surgical histopathology. The postoperative course of the patient was uncomplicated and his tarsal tunnel symptoms resolved. This represents a case of extensive synovial chondromatosis involving all flexor tendons in the tarsal tunnel that was correctly diagnosed by clinical and imaging findings, which required early surgical resection to avoid long-term neurovascular complications.
Resumo A condromatose sinovial é uma condição rara caracterizada por metaplasia condrogênica benigna do tecido sinovial extra-articular, que geralmente afeta uma única bainha tendínea da mão ou do pé. O objetivo é relatar o caso raro de um paciente com diagnóstico de condromatose sinovial extensa afetando todos os tendões flexores na topografia do túnel do tarso, suas características radiológicas, tratamento cirúrgico e desfecho clínico. Os autores apresentam um caso único de condromatose sinovial extensa em um homem de 48 anos envolvendo as bainhas dos tendões flexor longo do hálux, flexor longo dos dedos e tibial posterior, na topografia do túnel do tarso, com extensão para a região plantar do retropé. O sintoma inicial foi de compressão neurovascular (síndrome do túnel do tarso). A suspeita diagnóstica foi condromatose sinovial com base em evidências radiográficas e de ressonância magnética. O paciente foi submetido a ressecção cirúrgica do tumor, bem como a liberação do túnel tarsal e alongamento do tendão dos gastrocnêmios. O diagnóstico foi confirmado por exame histopatológico do espécime colhido no período intraoperatório. A evolução pósoperatória do paciente ocorreu sem complicações e os sintomas da síndrome do túnel do tarso cessaram. Os autores relatam um caso de condromatose sinovial extensa envolvendo todos os tendões flexores do túnel do tarso, corretamente diagnosticado por achados clínicos e radiológicos e que necessitou de ressecção cirúrgica precoce para evitar complicações neurovasculares em longo prazo.
Asunto(s)
Humanos , Masculino , Persona de Mediana Edad , Sinovitis , Condromatosis Sinovial/cirugía , Condromatosis Sinovial/patología , Condromatosis Sinovial/diagnóstico por imagenRESUMEN
La condromatosis sinovial se caracteriza por la formación de múltiples nódulos cartilaginosos intraarticulares del tejido subsinovial, que puede ser diagnosticada erróneamente debido a la ausencia de un examen físico, o de hallazgos en RM característicos en etapas iniciales. Se presenta un caso de una mujer de 33 años que consulta por dolor, pseudobloqueo y contractura en flexión de rodilla izquierda sin antecedente traumático previo. Debido a la sospecha de condromatosis sinovial de rodilla, se indicó la exploración artroscópica. Intraoperatoriamente se identificaron múltiples cuerpos sueltos intra y extraarticulares cartilaginosos: se realizó una sinovectomía radical y extracción de cuerpos libres. Al año de seguimiento, el paciente recuperó el rango completo de movimiento y retornó íntegramente a la actividad deportiva. Los resultados del presente informe indican que, en casos en los que existe una sospecha de condromatosis sinovial, la exploración artroscópica es un método eficaz para el diagnóstico y tratamiento con resultados satisfactorios. Tipo de estudio: Reporte de caso. Nivel de evidencia: IV
We report an unusual presentation of synovial chondromatosis of the knee in a 33-year-old women. At this unusual age and location, there is a greater probability of missed diagnosis, due to the lack of definite informative incidence, and difficulty in finding the lesions. In this case, intra and extraarticular multiple loose bodies were hidden. After careful arthroscopic inspection, we found numerous cartilaginous loose bodies and removed them with arthroscopy in association with sinovectomy. Synovial chondromatosis, is a rare, benign condition characterized by the formation of multiple intraarticular cartilaginous nodules from the subsynovial tissue. Synovial chondromatosis can be often misdiagnosed due to the lack of a specific physical exam or MRI findings in early stages. The present report examines a 33-year-old female with symptoms of left knee flexion contracture, pain mechanical locking without previous traumatic event. Following admittance, an arthroscopic exploration was conducted. Multiple cartilage-like intra and extraarticular loose bodies were identified in the patient's joints during surgery. Radical synovectomy and removal of loose bodies were performed. Following one year follow-up, the patient recovered full range of motion and returned to sports activities. The results of the present report indicate that, in cases where synovial chondromatosis is suspected, arthroscopic exploration is an effective method for diagnosis and treatment with satisfactory results. Type of Study: Case report. Level of evidence: IV
Asunto(s)
Adulto , Artroscopía/métodos , Condromatosis Sinovial/cirugía , Condromatosis Sinovial/diagnóstico , Articulación de la RodillaRESUMEN
ABSTRACT Synovial chondromatosis is a benign arthropathy rarely seen in diarthrodial joints. Extra-articular bilateral symmetrical synovial chondromatosis of shoulder is the rarest variety. The diagnosis is established with the help of imaging modalities and histopathological examinations. This report describes a case of a 39-year-old woman who presented with symmetrical, progressively increasing swelling over the bilateral shoulder region, of 12-18 months duration, with dull ache and restricted movements of the shoulder joints. Magnetic resonance imaging (MRI) and ultrasonography (USG) revealed large bilateral subacromial-subdeltoid bursal swelling with loose floating bodies. Surgical excision of extensive bilateral bursa was performed at four weeks of interval. Histopathological examination revealed synovial chondromatosis on either side. Postoperative recovery occurred without complications.
RESUMO A condromatose sinovial é uma artropatia benigna raramente vista em articulações diartrodiais. A condromatose sinovial simétrica bilateral extra-articular do ombro é a variedade mais rara. O diagnóstico é estabelecido com a ajuda de exames de imagem e histopatológicos. Este relato descreve o caso de uma paciente de 39 anos, com aumento de volume progressivo simétrico sobre a região bilateral do ombro com 12-18 meses de duração com dor entorpecido e limitação dos movimentos das articulações do ombro. A ressonância magnética e a ultrassonografia revelaram um grande aumento de volume da bursa subacromial subdeltoidea bilateral com corpos livres flutuantes. A excisão cirúrgica extensa da bursa bilateral foi feita com quatro semanas de intervalo. O exame histopatológico revelou condromatose sinovial em ambos os lados. A recuperação pós-operatória transcorreu sem complicações.
Asunto(s)
Humanos , Femenino , Adulto , Hombro , Condromatosis Sinovial/cirugía , Condromatosis Sinovial/diagnóstico por imagen , CondromatosisRESUMEN
La condromatosis sinovial es una entidad patológica poco frecuente donde se desarrollan cuerpos de aspectos cartilaginosos a partir de la membrana sinovial de articulaciones, bursas o vainas tendinosas, generando cuerpos libres productores de la sintomatología. Presentamos un caso de 16 años que consulta con dolor de hombro derecho, progresivo sin antecedente de trauma previo, de 3 años de evolución. Se realizan estudios imagenológicos correspondientes llegando a la conclusión diagnostica de condromatosis sinovial de hombro. Se realiza el tratamiento quirúrgico definitivo por artroscopía, logrando remisión de los síntomas y evolución favorable sin recidiva hasta los 5 años de evolucion.
Synovial chondromatosis is a rare pathological entity where cartilaginous aspects develop from the synovial membrane of joints, bursae or tendinous sheaths, generating free bodies that produce symptoms. We present a 16-year-old male with 3 years of right shoulder pain, progressive with not previous trauma. Imaging studies are carried out, arriving at the diagnostic of synovial chondromatosis of the shoulder. The final surgical treatment is performed by arthroscopy, achieving remission of symptoms and favorable evolution without recurrence until 5 years of evolution.
Asunto(s)
Humanos , Adolescente , Articulación del Hombro/cirugía , Artroscopía/métodos , Condromatosis Sinovial/cirugía , Dolor de Hombro , Recuperación de la Función , Resultado del TratamientoRESUMEN
La condromatosis sinovial es una enfermedad de etiología desconocida, poco frecuente, benigna, caracterizada por la formación de nódulos cartilaginosos metaplásicos dentro de la sinovial, bursa o vaina de tendones. Estos nódulos pueden desprenderse y convertirse en cuerpos libres dentro de la articulación. Afecta a los hombres dos veces más que las mujeres y, por lo general, ocurre entre la tercera y quinta década de la vida. Este proceso monoarticular afecta más comúnmente a la rodilla, seguido de la cadera, el codo, el hombro y tobillo. La afección extraarticular puede ocurrir si la proliferación de cuerpos libres rompen a través de la cápsula de la articulación o si las estructuras sinoviales fuera de la articulación (por ejemplo, vainas de los tendones, bursas) están involucradas. Se presenta un paciente de sexo masculino de 30 años de edad que acude por dolor en tobillo derecho, disminución del rango de movilidad y limitación progresiva para la deambulación de un año y medio de evolución. Al examen físico presentaba clínica de síndrome friccional anterior en tobillo, rango de movilidad limitado (flexión plantar 25º y dorsal 20º. No presenta antecedentes de inestabilidad previa ni comorbilidades. Con la presunción diagnóstica de condromatosis sinovial de tobillo se decidió llevar a cabo una artroscopia anterior de tobillo diagnóstica y terapéutica. Al año postoperatorio presentaba 30º de flexión plantar y 25º de flexión dorsal, sin dolor y sin recurrencia en las imágenes radiográficas. El escore del American Orthopaedic Foot and Ankle Society mejoro de 49 puntos en el preoperatorio a 97 puntos en el postoperatorio. En el caso presentado la artrosocopía permitió el tratamiento de la condromatosis sinovial de tobillo con buen resultado al año.
Synovial chondromatosis is an uncommon, benign disease of unknown etiology characterized by the formation of metaplastic cartilaginous nodes within the synovial bursa or tendon sheath. These nodules may break off and become free in the articular joint. It affects men twice more than women and usually occurs between the third and fifth decade of life. This monoarticular process most commonly affects the knee, followed by the hip, elbow, shoulder and ankle. The extra-articular condition can occur if the proliferation of loose bodies break through the joint capsule or synovial structures outside the joint (eg, tendon sheaths, bursae) are involved. We present a male patient of 30 years old who consulted for right ankle pain, decreased range of motion and progressive ambulation limitation for a year and a half of evolution. Physical examination showed clinical anterior impingement, limited dorsal and plantar flexion (25 and 20 degrees respectively), without instability. No history of relevance. With the suspected diagnosis of synovial chondromatosis it was decided to carry out a diagnostic and therapeutic arthroscopy of the ankle. At a year postoperative showed 30 degrees plantar flexion and 25 degrees of dorsiflexion, painlessly and without recurrence in radiographic images. The American orthopaedic foot and ankle society score improves from 49 in the preop to 97 in the postop. Arthroscopic treatment for ankle synovial chondromatosis provides acceptable improvement of clinical symptoms and range of motion at a year postop.
Asunto(s)
Adulto , Articulación del Tobillo/cirugía , Artroscopía/métodos , Condromatosis Sinovial/cirugía , Dolor , Rango del Movimiento Articular , Recuperación de la Función , Resultado del TratamientoRESUMEN
Objetivo: presentar las características clínicas y por imágenes de un paciente con condromatosis sinovial en la articulación temporomandibular izquierda y el tratamiento realizado. Caso clínico: la condromatosis sinovial es una artropatía benigna crónica, progresiva y proliferativa, que suele afectar las articulaciones largas y, con poca frecuencia, la articulación temporomandibular. En este último caso, la enfermedad se caracteriza por el desarrollo de nódulo cartilaginosos en el espacio articular. Los síntomas clínicos de condromatosis sinovial en la ATM son dolor, inflamación, crepitación, maloclusión y disfunción. Esta sintomatología es común a la de otras patologías en la misma articulación, por lo que la sospecha y el diagnóstico de condromatosis sinovial son en sí un desafío. Conclusión: la condromatosis sinovial es una patología poco frecuente en la articulación temporomandibular. Una vez diagnosticada, yta sea en estadíos tempranos o avanzados, se puede optar por diversos tratamientos, con excelentes pronósticos.
Asunto(s)
Humanos , Masculino , Anciano , Condromatosis Sinovial/complicaciones , Condromatosis Sinovial/diagnóstico , Trastornos de la Articulación Temporomandibular/etiología , Artroscopía/métodos , Condromatosis Sinovial/cirugía , Diagnóstico por Imagen/métodos , Pronóstico , Procedimientos Quirúrgicos Orales/métodos , Signos y SíntomasRESUMEN
La condromatosis sinovial es una metaplasia cartilaginosa del tejido sinovial de las articulaciones. Es una enfermedad de etiología desconocida e infrecuente. Su localización en la articulación temporomandibular es más rara aún. Se describe el caso clínico de una paciente con diagnóstico de condromatosis sinovial de la articulación temporomandibular tratada con éxito mediante un abordaje quirúrgico combinado: externo y con endoscopios de 4 mm. Se realizó una revisión de la bibliografía sobre la información existente de la condromatosis sinovial.
Synovial chondromatosis is a cartilaginous metaplasia of the synovial tissue of joints. It is a disease of unknown etiology and infrequent. Its location in the temporomandibular joint is still more unusual. The case of a patient is described with a diagnosis of synovial chondromatosis of the temporomandibular joint successfully treated with a combined surgical approach: external and with 4 mm endoscopes. A review of the literature was conducted on the existing information on synovial chondromatosis.
A condromatose sinovial é uma metaplasia cartilaginosa do tecido sinovial das articulações. É uma doença de etiologia desconhecida e pouco frequente. A sua localização na articulação temporomandibular é ainda mais rara. Descreve-se o caso clínico de uma paciente com diagnóstico de condromatose sinovial da articulação temporomandibular tratada com sucesso mediante uma abordagem cirúrgica combinada: externa e com endoscópios de 4 mm. Realizou-se uma revisão da bibliografia sobre a informação existente da condromatose sinovial.
Asunto(s)
Femenino , Humanos , Anciano , Condromatosis Sinovial/diagnóstico , Condromatosis Sinovial/cirugía , Endoscopía , Articulación Temporomandibular/cirugíaRESUMEN
Introducción: La condromatosis sinovial se define como una lesión metaplásica benigna, de baja incidencia en cadera. La técnica ideal de tratamiento genera controversia por la probable recurrencia y la progresión degenerativa descrita para técnicas tanto a cielo abierto como artroscópicas. El objetivo de este trabajo es reportar la técnica quirúrgica y los resultados a corto plazo en una serie de pacientes con condromatosis sinovial de cadera tratados por vía artroscópica. Materiales y Métodos: Entre abril de 2007 y mayo de 2011, 10 pacientes (9 mujeres y 1 hombre, edad promedio 38 años; rango 17-53) fueron operados por vía artroscópica a causa de una condromatosis sinovial de cadera. Se evaluaron la técnica quirúrgica, los resultados clínicos y radiológicos, y el grado de satisfacción con el procedimiento. La escala funcional de Harris modificada preoperatoria fue de 51 puntos (rango 49-54). La histología diferida confirmó el diagnóstico en todos los casos. El seguimiento prospectivo fue, en promedio, de 35 meses (rango 24-47). Resultados: En todos los casos, se realizó una técnica artroscópica convencional para extraer cuerpos libres y sinovectomía parcial anterolateral. En tres pacientes, se amplió la incisión de uno de los portales para extraer cuerpos de gran diámetro. La escala funcional de Harris modificada posoperatoria fue, en promedio, de 88 puntos (rango 85-91). No se observó progreso degenerativo articular radiológico en el último control. Todos los pacientes se mostraron satisfechos con el procedimiento. No se registraron complicaciones. Conclusiones: Los resultados a corto plazo favorables coinciden con los publicados. Los pacientes con condromatosis sinovial de cadera pueden ser tratados por vía artroscópica en forma segura y eficaz. Diseño del estudio: Estudio terapéutico Nivel de evidencia: IV...
Background: Synovial chondromatosis is defined as a benign metaplastic lesion, with a low incidence in hips. The ideal treatment technique is controversial due to the probable recurrence and degenerative progression described with both arthroscopic and open surgery. The aim of this study is to report the surgical technique and shortterm results in a series of patients with synovial chondromatosis treated with arthroscopic hip. Methods: From April 2007 to May 2011, 10 patients (9 women and a man; average age 38 years; range 17-53) underwent hip arthroscopy for synovial chondromatosis. Surgical technique, clinical and radiological results, and satisfaction with the procedure were evaluated. The preoperative modified Harris hip functional scale was 51 points (range 49-54). Delayed histology confirmed diagnosis in all cases. Prospective follow-up averaged 35 months (range 24-47). Results: The conventional arthroscopic technique to extract loose bodies and partial anterolateral synovectomy were performed in all patients. In three patients incision of one of the portals was extended to extract bodies of large diameter. The postoperative modified Harris hip functional scale averaged 88 points (range 85-91). No radiographic joint degenerative progress was seen at the last control. All patients were satisfied with the procedure. There were no complications. Conclusions: Favorable short-term results are consistent with those reported in the literature. Patients with synovial chondromatosis can be treated with hip arthroscopy safely and effectively. Design of the Study: Therapeutic. Level of Evidence: IV...
Asunto(s)
Adulto , Adulto Joven , Persona de Mediana Edad , Articulación de la Cadera/cirugía , Artroscopía/métodos , Condromatosis Sinovial/cirugía , Condromatosis Sinovial/diagnóstico , Cuerpos Libres Articulares/cirugía , Cuerpos Libres Articulares , Dimensión del Dolor , Estudios Prospectivos , Rango del Movimiento Articular , Resultado del TratamientoRESUMEN
La ostecondondromatosis sinovial es una patología infrecuente que afecta las articulaciones, produciendo nódulos cartilaginosos que ocasionan dolor y disminución de la movilidad: ante el avance del cuadro, el tratamiento quirúrgico con la resección de los cuerpos libres y la sinovectomía está indicado. Se presentan 3 casos de condromatosis sinovial del hombro tratados en forma artroscópica.
Asunto(s)
Masculino , Adulto , Articulación del Hombro/cirugía , Artroscopía/métodos , Condromatosis Sinovial/cirugíaRESUMEN
La condromatosis sonovial es un proceso beningo infrecuente que afecta las articulacione y otras estructuras que contienen tejido sinovial. Se presenta el caso de una mujer de 46 años con condromatosis sinovial sintomática de cadera derecha, en etapa inicial, localizada en la fosa acetabular. El tratamiento fue la resección abierta de la lesión mediante luxación quirúrgica de la cadera. No hubo complicaciones intra o postoperatorias y la osteotomía consolidó adecuadamente. Al último seguimiento, la paciente no tiene dolor y realiza una vida normal.
Asunto(s)
Humanos , Adulto , Femenino , Persona de Mediana Edad , Condromatosis Sinovial/cirugía , Luxación de la Cadera/cirugíaRESUMEN
Se presenta el caso de una paciente, del sexo femenino, con un condrosarcoma sinovial derivado de una transformación maligna de condromatosis sinovial. Se discuten los hallazgos en imágenes e histológicos. Se revisan y comentan los casos previamente publicados.