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Primary synovial chondromatosis

Case contributed by Dr John Grieve

Presentation

Painful, swollen ankle joint. Unable to weight bear. No obvious history of trauma. Afebrile.

Patient Data

Gender: Female
X-ray

There is a well defined ovoid mass anterior to the ankle joint.  The mass exhibits "rings and arcs" pattern of of calcification in keeping with a chondroid matrix.  There appears to be some pressure remodeling of the underlying talus. 

There is a soft tissue density mass with a calcified border arising from the anterior aspect of the ankle joint.  Medial to it there is a smaller focus which has a cortex and internal trabeculation in keeping with an osteoid matrix.

Sagittal images demonstrate pressure remodeling of the underlying talus and anterior lip of the distal tibia, which was suspected on the plain film.

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