Arthroscopic Treatment of Localized Synovial Chondromatosis of the Posterior Knee Joint

Abstract

Synovial chondromatosis is an uncommon, benign neoplastic process typically affecting adult men and most commonly involving the knee, hip, and elbow joints. Intra-articular primary synovial chondromatosis in the knee joint may be localized or generalized. The symptoms associated with localized synovial chondromatosis may include diffuse pain, swelling, restricted motion, crepitus with symptoms of locking and giving way, and posteromedial tenderness mimicking medial meniscus tear. Diagnosis is usually established with magnetic resonance imaging (MRI) and confirmed by histological examination. To our knowledge, synovial chondromatosis of the knee joint in the posteromedial corner has not been reported in the literature. A 53-year-old woman presented with pain in the posteromedial joint line, mild effusion, and occasional locking. Diagnostic evaluation included radiographs, routine blood investigations, and MRI. Radiographs showed no abnormalities. Magnetic resonance imaging showed a small cystic lesion including multiple calcifications between the posterior horn of the medial meniscus and the posterior capsule. Arthroscopic synovectomy and removal of small loose bodies through the trans-septal portal was performed, which relieved her symptoms completely. Arthroscopy using the posterior trans-septal portal allows for better visualization and access, and might be useful to successfully treat localized synovial chondromatosis within the knee joint.