Primary synovial osteochondromatosis
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There are multiple, circular, similarly sized osseous densities located anteriorly at the level of the tibiotalar joint space, in an expected intracapsular location.
This case represents a classic example of primary synovial osteochondromatosis. The features that distinguish primary from secondary synovial osteochondromatosis include maintained joint space and no other associated degenerative changes at the joint involved. Also, the uniformity of the size of the synovial osteochondromas in this case favor primary over secondary, as in secondary there are usually multiple synovial osteochondromas that vary widely in size.