同: osteo

WordNet

relating to or secreting synovia
viscid lubricating fluid secreted by the membrane lining joints and tendon sheaths etc. (同)synovial_fluid

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2016/06/28 01:51:22」(JST)

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Synovial chondromatosis (synonyms include synovial osteochondromatosis, primary synovial osteochondromatosis, and synovial chondrometaplasia) is a disease affecting the synovium, a thin flexible membrane around a joint. It is also known as Reichel's syndrome or Reichel-Jones-Henderson syndrome, named after Friedrich Paul Reichel, Hugh Toland Jones and Melvin Starkey Henderson.^[1]

Symptoms

Patients usually complain of pain in one joint, which persists for months, or even years, does not ease with exercise, steroid injection or heat treatment, shows nothing on X-ray, but shows a definite restriction of movement.

There are 3 defined stages to this disease:

early: no loose bodies but active synovial disease;
transitional: active synovial disease, and loose bodies;
late: loose bodies but no synovial disease;

In the early stages of the disease it is often confused with tendinitis and/or arthritis. Once it reaches transitional the loose bodies become apparent with X-ray in greater than 70% of cases, with MRI often showing where xray fails. In experienced hands, US is also useful for the diagnosis.^[2]

In the disease, the thin flexible membrane of the synovium gradually forms blisters which calcify and enlarge. These nodules eventually break free and float around the joint space becoming larger – these add to the discomfort and stiffness of the joint.

The disease is rare and little known and there is currently no known cure. The affected tissue will show up as a semi-solid mass in a MRI scan, final diagnosis is usually confirmed by taking a biopsy.

Synovial chondromatosis occurs twice as commonly in males as females and usually in their forties. However, online communities for synovial chondromatosis patients have yielded a stark contrast, with equal representation from both genders and members diagnosed as young as late teenage/early 20s.

The disease generally affects only one of the larger weight bearing joints (hip, ankle, knee) – although the elbow, and wrist can also be affected. Rarely involves the temporal mandibular joint.^[3]

Treatment

Treatment is frequently by means of removal of the loose bodies and of a partial or full Synovectomy (removal of the synovium)

Full synovectomy is a moderately major operation and involves completely exposing the joint and removing the affected tissue. Partial synovectomy is normally done arthroscopically. Synovectomies are normally carried out by shaving the lining of the knee but there are other ways of achieving this by either freezing the synovium or by the use of radiation treatment.

The need for further procedures is greater than 25% although normally the frequency of the required removal of loose bodies is reduced by the previous synovectomy. There have been documented cases of malignant transformation however this is rare.

Whilst the condition can be described as a ‘benign growth’ it seldom affects more than one joint, and does not usually affect surrounding tissue.

References

FletcherCDM, UnniKK, MertensF, editors. Pathology and genetics of tumours of soft tissue and bone. World Health Organization classification of tumours. Lyon: IARC Press, 2002.

Webpage and Discussion Board for Sufferers of SOC

^ http://www.whonamedit.com/synd.cfm/2114.html
^ Arend CF. Ultrasound of the Shoulder. Master Medical Books, 2013. Free chapter on ultrasound findings of synovial chondromatosis affecting the subacromial-subdeltoid bursa available at ShoulderUS.com
^ Fuller E, Bharatha A, Yeung R, Kassel EE, Aviv RI, Howard P, Symons SP. Case of the month #166: synovial chondromatosis of the temporal mandibular joint. Canadian Association of Radiologists Journal. 2011 May; 62(2):151-153.

UpToDate Contents

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1. 成人における膝関節腫瘍のX線評価 radiologic evaluation of knee tumors in adults
2. 成人における股関節痛の放射線評価 radiologic evaluation of the painful hip in adults
3. 膝関節の炎症性関節炎に対する滑膜切除 synovectomy for inflammatory arthritis of the knee
4. 肩痛の放射線評価 radiologic evaluation of the painful shoulder
5. 膝滑液包炎 knee bursitis

English Journal

It's not what it looks like: challenges in diagnosis of synovial lesions of the knee joint.

Dash KK1, Gavai PV2, Wade R3, Rajani A4,5.
Journal of experimental orthopaedics.J Exp Orthop.2016 Dec;3(1):5. doi: 10.1186/s40634-016-0039-3. Epub 2016 Jan 29.
BACKGROUND: With the advent of MRI (Magnetic Resonance Imaging), Synovial lesions around knee are being more and more easily detected. Synovial lesions of knee present with boggy swelling, effusion, pain, and restriction of motion. Differential diagnoses of such lesions include pigmented villonodula
PMID 26915005

Solitary synovial chondromatosis arising in the gluteus maximus bursa: computed tomography and magnetic resonance imaging findings.

Sumida K1, Kobayashi N2, Nambu A2, Tago M2, Shibuya I3, Kawamoto M4.
Acta radiologica open.Acta Radiol Open.2016 Mar 1;5(3):2058460115617352. doi: 10.1177/2058460115617352. eCollection 2016.
Chondral tumors in soft tissue are referred to as soft-tissue chondromas or extraskeletal chondromas, or as synovial chondromatosis if they arise in synovial tissue. We report the case of a 29-year-old man with synovial chondromatosis, also called synovial osteochondromatosis, which appeared in a so
PMID 26998347

Uncommon Primary Synovial Chondromatosis Involving Only the Infrapatellar Fat Pad in an Elderly Patient.

Lee DH1, Jeong TW2.
Knee surgery & related research.Knee Surg Relat Res.2016 Mar;28(1):79-82. doi: 10.5792/ksrr.2016.28.1.79. Epub 2016 Feb 29.
Primary synovial chondromatosis is a rare condition of idiopathic synovial chondrometaplasia and usually occurs during the third to fifth decades of life. Conversely, secondary synovial chondromatosis results from the growth of separated particles from articular cartilage or osteophytes in patients
PMID 26955617

Japanese Journal

滑膜性骨軟骨腫症と関節円板の石灰化を併発した顎関節部ピロリン酸カルシウム結晶沈着症の1例

片山良子,栗田賢一,福田幸太他
日本口腔外科学会雑誌 58(6), 366-370, 2012-06-00
NAID 40019370332

中頭蓋窩への進展を伴う顎関節滑膜軟骨腫症の1例

儀武啓幸,佐藤文明,木野孔司
TMJ : journal of Japanese Society for Temporomandibular Joint = 日本顎関節学会雑誌 24(1), 17-21, 2012-04-20
滑膜軟骨腫症は，滑膜に内包，あるいは滑膜から遊離した軟骨塊または多数の軟骨粒が，関節腔に認められる病変であり，膝関節や肘関節などに発症することが多いが，顎関節に発症することは比較的まれである。今回われわれは，中頭蓋窩に進展していた右側顎関節の滑膜軟骨腫症の治療を経験したので報告する。患者は72歳の男性で，右側顎関節部の疼痛と，下顎偏位を伴う咬合不全を主訴に，東京医科歯科大学歯学部附属病院顎顔面外 …
NAID 10030625028