Synovial osteochondromatosis is a rare disease where nodules develop in the synovial lining of joints, causing pain and mobility difficulties. It can be primary or secondary and is treated with arthroscopic surgery to remove loose bodies and lumps. The disease can recur after surgery.
Synovial osteochondromatosis, or SOC, is a rare disease in which the lining of the joints, known as the synovial lining, grows abnormally. Lumps, or nodules, develop in the lining and can rupture so that the joint fills with what are called loose bodies. The disease is benign, or noncancerous, but can cause pain, swelling, and mobility difficulties. Synovial osteochondromatosis occurs most frequently in middle-aged men and is usually found in only one joint, with the knee being most commonly affected. Removal of floaters, using arthroscopic surgery, can be done to treat the disease.
There are two types of synovial osteochondromatosis, referred to as primary and secondary forms of the disease. Primary synovial osteochondromatosis occurs on its own and the cause is not known. The secondary form of the disease develops in association with existing joint disorders such as arthritis or fractures. Existing disease can lead to fragments of bone or cartilage becoming embedded in the synovial lining, causing the cartilage around them to develop abnormally. Both primary and secondary synovial osteochondromatosis are rare diseases, and both are examples of what are called soft tissue disorders.
The loose bodies that develop in the joint due to synovial osteochondromatosis are able to receive nutrients from the synovial fluid in which they float. This means that loose bodies can continue to grow even if they are detached from the joint lining. Sometimes a process known as calcification occurs, where calcium enters loose bodies, causing hardening. Calcified loose bodies are easier to see on X-rays, while other tests such as computed tomography or CT may be needed to see those that have not undergone calcification. Loose bodies may be associated with an increased amount of joint fluid, known as an effusion.
Treatment of synovial osteochondromatosis usually involves a form of orthopedic surgery, known as arthroscopy. Arthroscopy is a type of keyhole surgery, in which the operation is performed using specially adapted instruments inserted through small openings, together with a viewing device called an arthroscope. During the procedure, loose bodies are removed from inside the joint and any lumps embedded in the synovial lining are shaved off. While this form of surgery has been shown to work well for diseases affecting the knee and shoulder, it is still uncertain whether it is helpful in cases of synovial osteochondromatosis of the ankle or hip. In some people, the condition can recur after surgery.
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