scholarly journals Recurrence of Primary Synovial Chondromatosis (Reichel’s Syndrome) in the Ankle Joint following Surgical Excision

2021 ◽  
Vol 2021 ◽  
pp. 1-3
Author(s):  
Thomas Gatt ◽  
Mark Portelli
Keyword(s):  
Surgical Excision ◽  
Synovial Chondromatosis ◽  
Postoperative Recovery ◽  
Strenuous Exercise ◽  
Loose Bodies ◽  
Management Options ◽  
Time Period ◽  
Rare Benign Tumour ◽  
Short Time

Primary synovial chondromatosis, or Reichel’s syndrome, is a rare benign tumour arising from the synovial lining of a joint. We present the case of a 25-year-old male with Reichel’s syndrome of the ankle, with subsequent recurrence following open retrieval of loose bodies. The initial presentation was of lateral malleolus discomfort which limited moderately strenuous exercise. Clinical examination showed a mild effusion and pain on extremes of movement. Imaging confirmed the presence of multiple loose bodies within the anterior and anterolateral recesses of the ankle. Open removal of 27 loose bodies from the joint was performed, with good postoperative recovery. He represented with pain 9 months later, with imaging of the ankle showing reaccumulation of loose bodies to a lesser extent. A trial of conservative management was opted for. Reichel’s syndrome confined to the ankle is an exceedingly rare diagnosis, with few cases reported in the literature. This case saw the recurrence of the disease in a short time period despite successful surgery in the first instance. Management options to treat recurrence include repeat retrieval of foreign bodies, synovectomy, radiotherapy, or arthrodesis. While the prognosis is favourable, a low risk of malignant potential warrants adequate patient follow-up.

Anterior and Posterior Arthroscopic Treatment of Primary Synovial Chondromatosis of the Ankle

2020 ◽  
pp. 107110072097096
Author(s):  
Ivan Bojanić ◽  
Mihovil Plečko ◽  
Ana Mataić ◽  
Damjan Dimnjaković
Keyword(s):  
Malignant Transformation ◽  
Case Series ◽  
Synovial Chondromatosis ◽  
Unknown Etiology ◽  
Loose Bodies ◽  
Retrospective Case ◽  
Level Of Evidence ◽  
Patient’S Satisfaction ◽  
Operative Session

Background: Primary synovial chondromatosis (PSC) is a progressive disorder of unknown etiology resulting in formation of multiple loose bodies. If left untreated, it may lead to degenerative changes or malignant transformation to chondrosarcoma. Methods: Seventeen patients who underwent combined posterior and anterior ankle arthroscopy within the same operative session and had histologically confirmed PSC were included in this retrospective study. American Orthopaedic Foot & Ankle Society (AOFAS) Ankle-Hindfoot score was used to evaluate ankle function preoperatively and at a final follow-up. A 3-question survey was used to evaluate patient’s satisfaction at the final follow-up. Results: In 14 patients, loose bodies were found in both compartments of the ankle, in 2 only in the anterior compartment, and in 1 only in the posterior compartment. All patients had evident signs of synovial inflammation in both compartments. The AOFAS Ankle-Hindfoot score increased from the preoperative median score of 65 (range, 29-90) to 95 (range, 65-100) at the final follow-up. Fourteen patients reported they were extremely satisfied with the outcome, 1 was moderately satisfied, and 2 were dissatisfied. No cases of recurrence of synovitis or loose body formation were noted, nor any signs of malignant transformation during the follow-up period. Conclusion: We believe the risk of recurrence of PSC, which is in close relation to malignant transformation, can be minimized by performing a complete synovectomy of the ankle. Our experience and review of literature makes us believe that ankle PSC should be regarded as a whole joint disorder. Performing a combined posterior and anterior arthroscopic procedure within the same operative session should always be considered in patients with ankle PSC. Level of Evidence: Level IV, retrospective case series.

scholarly journals Nasolabial cyst: case report and review of management options

BMC Surgery ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Abdulhakeem Almutairi ◽  
Abeer Alaglan ◽  
Mazyad Alenezi ◽  
Sultan Alanazy ◽  
Osama Al-Wutayd
Keyword(s):  
Soft Tissue ◽  
Nasal Obstruction ◽  
Surgical Excision ◽  
Mass Effect ◽  
Treatment Modalities ◽  
Open Approach ◽  
Management Options ◽  
Case Presentation ◽  
Complete Surgical Excision

Abstract Background Nasolabial cysts are rare, non-odontogenic, soft-tissue cysts that develop between the upper lip and nasal vestibule with an overall incidence of 0.7% out of all maxillofacial cysts. The predominant presentation of a nasolabial cyst is a painless localized swelling with varying degrees of nasal obstruction. Several treatment modalities have described in the management of the nasolabial cyst. In this paper, we present a case of a nasolabial cyst in a 44 years old man with discussions of the treatment modalities in the lights of the literature. Case presentation We present a case of a nasolabial cyst in a 44-year-old man that slowly increased in size through a period of 3 years, with associated mild pain and nasal obstruction. It had caused a mass effect upon the maxilla, resulting in scalloping. The cyst was excised entirely with no evidence of recurrence at the two months follow up. Conclusions The nasolabial cyst is a rare soft-tissue cyst. Complete surgical excision using an open approach performed to our case, which considered with the complete endoscopic removal of the best treatment for the nasolabial cysts with a rare recurrence rate.

scholarly journals Treatment Response to a Double Administration of Constraint-Induced Language Therapy in Chronic Aphasia

2018 ◽  
Vol 61 (7) ◽  
pp. 1664-1690 ◽  
Author(s):  
Jennifer Mozeiko ◽  
Emily B. Myers ◽  
Carl A. Coelho
Keyword(s):  
Standardized Tests ◽  
Treatment Period ◽  
Response To Treatment ◽  
Language Therapy ◽  
Standardized Measures ◽  
Discourse Production ◽  
Time Period ◽  
Chronic Aphasia ◽  
Short Time

PurposeThis study investigated changes in oral–verbal expressive language associated with improvements following 2 treatment periods of constraint-induced language therapy in 4 participants with stroke-induced chronic aphasia. Generalization of treatment to untrained materials and to discourse production was also analyzed, as was the durability of the treatment effect.MethodParticipants with aphasia were assessed using standardized measures and discourse tasks at 3 to 4 time points to document behavioral changes throughout each of two 30-hr treatment periods of constraint-induced language therapy. Daily probes of trained and untrained materials were also administered.ResultsDespite participant heterogeneity, behavioral results for each person with aphasia indicated a positive response to treatment following each treatment period indicated by performance on standardized tests, trained materials, or both. Treatment effects generalized to some degree to untrained stimuli and to discourse measures and were generally maintained at follow-up testing.ConclusionsData support the utility of a 2nd treatment period. Results are relevant to rehabilitation in chronic aphasia, confirming that significant language gains continue well past the point of spontaneous recovery and can occur in a relatively short time period. Importantly, changes are not confined to a single treatment period, suggesting that people with aphasia may benefit from multiple doses of high-intensity treatment.

Pediatric Subtalar Joint Synovial Chondromatosis

2015 ◽  
Vol 105 (5) ◽  
pp. 435-439 ◽  
Author(s):  
Balaji Saibaba ◽  
Pebam Sudesh ◽  
Gokul Govindan ◽  
Mahesh Prakash
Keyword(s):  
Lower Limb ◽  
Subtalar Joint ◽  
Clinical Presentation ◽  
Surgical Excision ◽  
Synovial Chondromatosis ◽  
Age Group ◽  
The Third ◽  
Synovial Osteochondromatosis ◽  
Pediatric Age Group

Synovial chondromatosis is a rare, usually benign disorder affecting the population predominantly in the third and fourth decades of life and mainly involving the large weightbearing joints of the lower limb—the knees and the hip. In this report, we highlight an unusual pediatric clinical presentation of synovial osteochondromatosis involving the subtalar joint and discuss its surgical management; we also provide a comprehensive up-to-date literature review of the disorder. This patient was successfully treated with en masse surgical excision. He has been doing well, with complete pain relief and improved range of motion at 1-year follow-up. An exceptional involvement of the subtalar joint and an unusual presentation in the pediatric age group makes this case unique.

scholarly journals A case of synovial chondromatosis of knee joint treated with total knee arthroplasty

2021 ◽  
pp. 221049172098381
Author(s):  
Sourav Kumar Pal ◽  
Konchada Srikant ◽  
Amlan Dash
Keyword(s):  
Total Knee Arthroplasty ◽  
Functional Outcome ◽  
Knee Arthroplasty ◽  
Articular Surface ◽  
Visual Assessment ◽  
Synovial Chondromatosis ◽  
Loose Bodies ◽  
Lysholm Knee Score ◽  
Total Knee

Synovial Chondromatosis is a rare disease of the synovial membrane characterised by formation of multiple loose bodies in a joint. Knee is the most common joint to be affected by this disease. Though, this disease can be managed by synovectomy and removal of loose bodies with a favourable functional outcome but in some cases where there is damage of articular cartilage, simple synovectomy might not be sufficient. Here, we present a case of right knee pain in a 53 year old male since 4 years with a established diagnosis of synovial chondromatosis. No other joint was affected. Pain was associated with a fixed flexion deformity and restriction of knee range of motion and multiple slipping bodies. Radiography showed multiple loose bodies in the tibio-femoral as well as in patello femoral compartment. MRI of knee revealed several damaged areas in the knee articular surface. As a result, decision was taken to perform total knee arthroplasty. Intraoperatively all the loose bodies were removed along with the affected synovium and arthroplasty was done. Patient was discharged in fourth post operative day with proper instructions and was called for follow up at 1 month, 3 month, 6 month, 1 year. Functional outcome was assessed by Tegner Lysholm knee score, Knee Society score and Visual Assessment Scale.

Synovial Chondromatosis of the Foot and Ankle

2008 ◽  
Vol 29 (3) ◽  
pp. 312-317 ◽  
Author(s):  
Daniel D. Galat ◽  
Duncan B. Ackerman ◽  
Daniel Spoon ◽  
Norman S. Turner ◽  
Thomas C. Shives
Keyword(s):  
Malignant Transformation ◽  
Surgical Excision ◽  
Synovial Chondromatosis ◽  
Loose Body ◽  
Normal Function ◽  
Low Grade ◽  
Foot And Ankle ◽  
Loose Bodies ◽  
Benign Condition ◽  
Institutional Review

Background: Synovial chondromatosis (SC) is a benign condition where the synovial lining of joints, bursae, or tendon sheaths undergoes metaplasia and ultimately forms cartilaginous loose bodies. Synovial chondromatosis of the foot and ankle is exceedingly rare, and outcomes following surgical excision are largely unknown. Materials and Methods: An Institutional Review Board-approved retrospective review of our institution's surgical database from 1970 to 2006 revealed 8 patients with SC of the foot and/or ankle confirmed by pathology. Results: Eight patients (4 female and 4 male) presented with pain, locking, or stiffness. Average age at presentation was 37 (range, 19 to 60) years. Average followup was 9.5 (range, 1 to 31) years. Six patients had involvement of the ankle, and two, the midfoot. Four patients underwent ankle synovectomy with loose body removal, and were pain-free at last followup. One patient underwent excision and midfoot arthrodesis for severe midfoot destruction. Three patients ultimately underwent below knee amputation, one for multiple recurrences and two for malignant transformation to low-grade chondrosarcoma. Conclusion: To our knowledge, this is the largest reported series of patients with SC of the foot and ankle. In half the patients, synovectomy with excision of loose bodies resulted in pain free return to normal function, without recurrence, at last followup. However, recurrence occurred in 3 (37.5%) of 8 patients with subsequent malignant transformation to low-grade chondrosarcoma occurring in 2 patients.

scholarly journals Synovial Chondromatosis of Hip in a Young Patient Salvaged With Mini Arthrotomy Without Hip Dislocation – A Case Report

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Neetin P. Mahajan ◽  
Prasanna Kumar G S ◽  
Ankit Marfatia ◽  
Akash V. Mane ◽  
Akhil Gop ◽  
...  
Keyword(s):  
Case Report ◽  
External Rotation ◽  
Anterior Part ◽  
Hip Dislocation ◽  
Surgical Excision ◽  
Complete Removal ◽  
Synovial Chondromatosis ◽  
Lateral View ◽  
Daily Routine ◽  
Loose Bodies

Introduction: Synovial chondromatosis is a rare, benign disorder of the synovium, which leads to loose body formation due to metaplastic transformation. It presents as multiple cartilaginous bodies in the synovial joints, bursae and in tendon sheaths. The diagnosis often delayed in hip involvement due to insidious onset of symptoms. Surgical management is essential to manage synovial chondromatosis, which includes hip dislocation and debridement, arthroscopic removal or using arthrotomy. Case Report: A 20-year-old male patient presented with complaints of pain in the left hip since 1 year and difficulty in walking for 6 months. On examination, the patient had mild tenderness over the left hip with the restriction of joint movements. He had flexion deformity of 30°, adduction and external rotation deformity of 10 and 15°, respectively. X-ray of the pelvis with both hips anteroposterior and left hip lateral view revealed calcified nodular mass over superior, inferior part of the femoral head, and anterior part of the neck with decreased joint space. As the patient was disabled with pain, stiffness especially restricted flexion and abduction and difficulty in daily routine activities, we planned for surgical excision of the loose bodies. Using lateral approach to the hip, intra-articular loose bodies were removed through arthrotomy without hip dislocation. At present 2-year follow-up, the patient is having full hip range of motion with no difficulty in squatting, sitting cross-legged, and radiological examination showed no evidence of recurrence. The patient is fully satisfied with the chosen treatment and participating in running and other sports. Conclusion: Although hip synovial chondromatosis are rare, early surgical intervention with complete removal of loose bodies, joint distraction for 6 weeks to allow healing, and early initiation of hip physiotherapy helps in getting better outcome even in patients with early stages of hip arthritis. The early surgical interv

scholarly journals Congenital granular cell epulis: A case series

2020 ◽  
Vol 9 ◽  
pp. 17
Author(s):  
Mustafa Okumuş ◽  
Adil Umut Zubarioğlu ◽  
Uğuray Payam Hacısalihoğlu
Keyword(s):  
Benign Lesion ◽  
Case Series ◽  
Granular Cell ◽  
Surgical Excision ◽  
Postoperative Recovery ◽  
Alveolar Ridge ◽  
Congenital Granular Cell Epulis ◽  
Malignant Lesions ◽  
Rule Out

Background: Congenital granular cell epulis (CGCE) is an extremely rare intraoral tumor of the newborn with a potential to disrupt feeding and produce respiratory distress. Case Series: We report two newborns presented with mass protruding off the mouth since birth. The mass was arising from alveolar ridge in both cases and dealt with surgical excision. Histopathology revealed it congenital granular cell epulis. Postoperative recovery and follow-up are uneventful. Conclusion: Congenital granular cell epulis is a benign lesion though not quite uncommon, may cause diagnostic challenges. Early excision and histopathology rule out malignant lesions.

scholarly journals Synovial Chondromatosis of the Subacromial Bursa Causing a Bursal-Sided Rotator Cuff Tear

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Julie A. Neumann ◽  
Grant E. Garrigues
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Tear ◽  
Synovial Chondromatosis ◽  
Loose Bodies ◽  
Complete Excision ◽  
Cuff Tear ◽  
Results Of Treatment ◽  
Partial Thickness ◽  
Shoulder Scores

Synovial chondromatosis is an uncommon condition, and involvement of the shoulder is even more rare. We report on a 39-year-old female who presented with symptoms, radiographic features, and intraoperative findings consistent with multiple subacromial loose bodies resulting in a partial-thickness, bursal-sided rotator cuff tear of the supraspinatus muscle. She was treated with an arthroscopic removal of loose bodies, complete excision of the subacromial/subdeltoid bursa, acromioplasty, and rotator cuff repair. To our knowledge, this is the first report of arthroscopic treatment for a bursal-sided, partial-thickness rotator cuff tear treated with greater than two-year clinical and radiographic follow-up. We utilized shoulder scores, preoperative and postoperative range of motion, and imaging to assess the results of treatment and surveillance for recurrence in our patient after two-year follow-up.

scholarly journals Giant solitary trichoepithelioma

2015 ◽  
Vol 04 (01) ◽  
pp. 041-044 ◽  
Author(s):  
Bhavuray Teli ◽  
P. B. Thrishuli ◽  
R. Santhosh ◽  
D. N. Amar ◽  
Shravan Rajpurohit
Keyword(s):  
World Literature ◽  
Standard Treatment ◽  
Surgical Excision ◽  
Network Access ◽  
Management Options ◽  
Open Access Journals ◽  
Research Initiative ◽  
The World ◽  
Adnexal Tumors

AbstractAdnexal tumors like giant solitary trichoepitheliomas are uncommon to most of us to permit a ready familiarity with them. Information regarding the genesis, clinical profile, behavior, and management options for this tumor is limited. There are 18 cases reported in the world literature till date. This review attempts to provide insight to this rare tumor. Our search included indexed literature from Pubmed, Directory of Open Access Journals, Health Inter Network Access to Research Initiative and Google databases in addition to standard dermatology texts. Giant solitary trichoepithelioma is a rare trichogenic tumor with potential for local recurrence. It has predilection for the older age, but may present at any age including at birth. It has close resemblance to basal cell carcinoma and other skin adnexal tumors - clinically, cytologically, and histologically. CD10, CD 34, PHLDA1 but not p75NTR are useful adjunct markers. Surgical excision is the standard treatment. Recurrence and possible transformation into BCC cautions follow up at regular intervals.

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