~ 862 ~ International Journal of Orthopaedics Sciences 2018; 4(1): 862-863 ISSN: 2395-1958 IJOS 2018; 4(1): 862-863 © 2018 IJOS www.orthopaper.com Received: 23-11-2017 Accepted: 2-12-2017 Dr. Dhirendra Kumar Dhiraj Associate Consultant, Department of Orthopaedics, Sir Gangs Ram Hospital, New Delhi, India Dr. Satish Kumar Associate Consultant, Department of Orthopaedics, Sir Ganga Ram Hospital, New Delhi, India Dr. Ravindra Singh Senior Registrar, Department of Orthopaedics, Sir Ganga ram hospital, New Delhi, India Dr. Shivendra Singh Registrar, DNB Trainee, Department of Orthopaedics, Sir Ganga Ram Hospital, New Delhi, India Correspondence Dr. Dhirendra Kumar Dhiraj Associate Consultant, Department of Orthopaedics, Sir Gangs Ram Hospital, New Delhi, India Synovial chondromatosis of the elbow: A case report and review of literature Dr. Dhirendra Kumar Dhiraj, Dr. Satish Kumar, Dr. Ravindra Singh and Dr. Shivendra Singh DOI: https://doi.org/10.22271/ortho.2018.v4.i1m.123 Abstract Synovial chondromatosis is not a very common disorder globally. We came across a case of chondromatosis of elbow which is even lesser involved joint as compared to other joints. Usual presentation is mechanical symptoms like locking or restriction of movement, pain and occasionally nerve compression or bursitis. It was treated by excision of the lesion along with synovium. Histopathology confirmed secondary chondromatosis. Although both surgical and non surgical treatments are described but large numbers of the patients are needed to know the indication and outcome of both the modalities. A long term follow-up is required to know the incidence of complications like secondary osteo-arthritis. Keywords: Synovial Chondromatosis, elbow Introduction Synovial chondromatosis is an uncommon benign condition in which metaplasia occurs within the synovial membrane of joint, sheath and tendon. Knee and hip are the most commonly affected joints as compared to shoulder, elbow and other joints. In the present article we would discuss a case of synovial chondromatosis of elbow who was treated at our hospital. Case Report A 37 year old right hand dominant male presented to our hospital with the complaint of pain and swelling in the left elbow of three months duration. Pain was insidious in onset, moderate in intensity, gradually progressive, aggravated by movement and relieved by rest and medication. The patient also had progressive restriction of the movement in the elbow. Physical examination revealed a firm swelling measuring 4x3 Cm in dimensions, on the medial aspect of the left elbow. The swelling was non adherent to the skin or bone, did not show any fluctuation or trans-illumination. Range of motion was restricted by 10 degree short of full extension and further flexion being possible till 120 degrees. Pronation and supination movements however were normal as compared to the opposite elbow. X-ray of the elbow was normal but MRI scan revealed calcified swellings on posterior, medial and to some extent on anterior aspect of the joint (Figure 1). All other investigations like ESR, CRP and Complete blood counts were normal. Based on clinical examination and investigations a provisional diagnosis of synovial swelling due to chondromatosis was made and patient advised to undergo surgical excision of the lesion. Patient underwent surgical process once declared fit at pre-anesthesia consultation. Lateral approach to the elbow was used to explore the lesion. Meticulous efforts were taken to save posterior interosseous nerve from injury and both the anterior and posterior extents of the lesion were approached through blunt dissection anterior and posterior. Multiple small, whitish cartilaginous bodies were found to be embedded in thickened synovium (Figure 2) which were excised along with subtotal synovectomy and sent for histopathology examination. Wound was closed in layers and compression bandage was given. Immediate post-op range of motion was allowed and sutures were removed in due course. Patient was followed up at regular intervals.