Arthroscopic removal of loose bodies in synovial chondromatosis of shoulder joint, unusual location of rare disease: A case report and literature review

Introduction Synovial chondromatosis is a benign mono-articular arthropathy affecting synovial joints. It mostly affects knee joint, followed by hip, elbow and wrist and is rarely reported for shoulder joint. The exact pathogenesis is not known. Usual symptoms are pain, difficulty in movement due to mechanical obstruction. The classic treatment is arthrotomy, removal of chondromatoid loose bodies and synovectomy. With recent advances arthroscopic removal of the chondromatoid loose bodies is a good option with relatively better post op rehabilitation and faster recovery. Case presentation 20 years old gentleman presented to clinic with history of pain in right shoulder for 2 years and decreased range of motion. There was no history of trauma or fever. Work up done and diagnosed with synovial chondromatosis. Arthroscopic removal of chondromatoid loose bodies and synovectomy was done. More than 120 loose bodies were removed. On two (2) years follow-up patient is pain free and having full range of motion at right shoulder joint. Discussion Synovial chondromatosis is rare in shoulder joint. The Primary synovial chondromatosis of unknown etiology, and secondary synovial chondromatosis due to degenerative joint disease. Classic treatment is arthrotomy and synovectomy. With recent advances, arthroscopic removal of loose bodies and synovectomy is also a good option for its treatment. In literature only few cases have been reported treated with arthroscopic removal of loose bodies and synovectomy. Conclusion Arthroscopic treatment of synovial chondromatosis is a good option if expertise is available. It causes less surgical trauma, better visualization during surgery, early recovery.
Highlights • Patient had history of recurrent pain, relieved on analgesics. • No intra articular injection was given before surgery. • Procedure was performed by an orthopedic surgeon with super-specialty in sports medicine. Post rehabilitaion started on first post op day, on follow up vistis patient was asymptomatic.