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Beitragstitel Synovial chondromatosis of the pisotriquetral joint
Beitragscode P12
  1. Tabea Breckwoldt Stadtspital Waid Vortragender
  2. Michael Dietrich Stadtspital Zürich
  3. Julia Sproedt Stadtspital Zürich - Waid und Triemli
Präsentationsform Poster
  • A02 - Hand
Abstract Introduction: Synovial chondromatosis (SC), also referred to as Reichel's syndrome, is a very rare condition, especially when the wrist is affected. As a benign metaplasia of the synovium that leads to the formation of mostly intraarticularly located, cartilaginous nodules, this condition can result in pain, swelling or limited range of motion of the affected joint. SC predominantly occurs in large joints such as the knee or the hip, but manifestations have been reported in various other joints. Typically, men between 30-60 years of age are affected. In respect to diagnostics, first indications can be found in radiographs, whereas the imaging of choice is Magnet-resonance imaging (MRI). Treatment usually consists of open or arthroscopic surgical excision, aiming for pain relieve and prevention of secondary lesions of the affected joint.

Methods: A retrospective case report of a 34-year old male patient who presentedwith recurring pain in his right wrist after a hyperextension trauma two years prior to presentation was conducted. Plain radiographs showed round radiopaque bodies proximal to the pisotriquetral joint. Patient’s history also revealed a Gitelman Syndrome (autosomal-recessive kidney tubule disorder) and HIV-Infection, which was sufficiently treated with antiretroviral therapy. Therefore, differential diagnosis included chondrocalcinosis due to the genetic renal condition. For further exploration, an MRI was performed.

Results: The MRI scan supported SC being the underlying pathology, additionally providing information about the exact position of the cartilaginous bodies. The patient was treated with open surgical excision of synovial tissue and five loose cartilaginous bodies from the pisotriquetral joint. The histopathological examination was consistent with SC. No perioperative complications occurred.

Conclusion: As symptoms and patient history of SC can be highly variable, awareness of this rare condition as a differential diagnosis needs to be established. Even though X-ray delivers almost pathognomonic hints towards this rare disease, it takes on average around five years until the correct diagnosis is given.