Synovial osteochondromatosis

Case contributed by Utkarsh Kabra

Presentation

Knee pain

Patient Data

Age: 45 years
Gender: Female
mri

Multiple tiny calcific foci are seen at posterosuperior aspects of medial femoral condyle, at anterior aspect of gracilis tendon with mild fluid. Few calcific foci are also seen at posterior aspect of distal femur along the attachment sites of medial and lateral gastrocnemius tendons.
Grade IV chondromalacia is seen along lateral articular facet and median ridge of patella. Grade II / III chondromalacia is seen along medial articular facet of patella. Mild partial thinning and loss of articular cartilage seen along medial femoral and tibial condyles with subtle subchondral marrow edema in medial femoral condyle. Mild irregularity of cartilage is seen along lateral tibial condyle. Early marginal osteophytes are seen along articular aspects.
Linear hyperintensity seen in posterior horn medial meniscus not intersecting with
articular margins (Grade 2 signal).
Mild diffuse thickening of posterior cruciate ligament is seen with maintained continuity, possibly mucoid degeneration.
Lobulated cystic lesion, measuring approx. 15 x 8mm is seen at posterior aspect of tibial attachment of posterior cruciate ligament, likely ganglion cyst.

CT confirming the presence of multiple calcific foci.

Case Discussion

Findings are consistent with synovial osteochondromatosis in a knee with other degenerative changes.

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