Shoulder arthroscopy
A view into the shoulder joint through mini incisions
20/6/08 7:36 PM

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Synovial chondromatosis of the shoulder


synovial chondromatosis of the shoulder, arthroscopic view
Arthroscopic view into a shoulder with synovial chondromatosis. Loose bodies are destroying the shoulder joint. A malignant transformation is possible.
Here you can read:
What is a synovial chondromatosis of the shoulder ?
Natural course of a synovial chondromatosis af the shoulder:
Signs and symptoms of a synovial chondromatosis of the shoulder ?
How to diagnose a shoulder chondromatosis ?
How to treat a synovial chondromatosis of the shoulder ?
What is a chondromatosis of the shoulder ?
It´s a disease of the synovial membrane. The synovial membrane is a layer at the inner side of the shoulder joint and producing the joint fluid. In rare cases ( less than 1% of the patients seen in a shoulder clinic ) synovial membrane cells turn into a kind of cartilage cells. So, they are changing into loose bodies that will destroy the shoulder joint. This is called a primary synovial chondromatosis.
In patients suffering from pain due to an arthrosis of the shoulder joint, synovial chondromatosis can develop concomitantly. Then we call it a secondary synovial chondromatosis.


Natural course of a synovial chondromatosis af the shoulder:
If left untreated, in the beginning you won´t feel much of a synovial shoulder chondromatosis. As time passes shoulder pain developes. This shoulder pain will last for several years until the synovial chondromatosis ends in an arthritis and destruction of the affected shoulder. Quite often, shoulder pain is debilitating and an arthroscopic or open lavage of the shoulder joint and synovectomy is necessary or a shoulder arthroplasty has to be implanted.


Signs and symtoms of a shoulder chondromatosis ?
In the early stage of the disease people don´t have any problems and it will be recognized accidentally. As the the disease progressives synovial chondromatosis is causing pain, cracking and / or swelling of the shoulder.


arthroscopic synovectomy of the shoulder

In an early stage of disease, synovectomy can stop the disease.


How to diagnose a shoulder condromatosis ?
Synovial chondromatosis can be diagnosed on MRI in the early stage. As disease develops, first, calcium deposits may be seen on x-rays. Such a single calcium deposit will turn into numerous loose or adherent bodies, which can be recognized on MRI or x-ray. Most of the time, these changes of the synovial membrane occur inside the shoulder joint. Sometimes it is possible that it occurs in the subacromial space or at the biceps tendon sheath.
arthritis of the shoulder due to a synovial chondromatosis
Numerous loose bodies of the synovial chondromatosis have caused a complete destruction of the shoulder joint. A shoulder prosthesis is necessary.


How to treat a synovial chondromatosis of the shoulder ?
In nearly all cases a synovial chondromatosis of the shoulder has to be operated, because it will lead - if untreated - to a severe arthritis of the shoulder. Arthroscopically or in an open operation loose bodies have to removed out of the shoulder joint, the synovia will be removed and cartilage be smoothend, depending on the amount of cartilage wear. If the chondromatosis is lying outside the shoulder joint, in the soft tissue, an open operation is more likely.


arthroscopic removal of a loose body of the shoulder in a synovial chondromatosis

Arthroscopic procedure of the left shoulder: a loose body of a synovial shoulder chondromatosis is removed.


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