Bilateral Synovial Chondromatosis of Knee Joint ina Patient with Rheumatoid Arthritis

Abstract

Synovial chondromatosis (SC) is an uncommon disorder of unknown etiology and is characterized by the presence of multiple cartilaginous nodules in the joint synovium or cavity. In this case presentation, we aimed to present a rare case of bilateral knee chondromatosis with different phases of Milgram’s classification secondary to rheumatoid arthritis (RA). A 47 years-old female patient, diagnosed with RA for 25 years, was presented with a history of 5 years knee pain when she was referred to our hospital. She had tenderness in her both knees with effusion and limited knee range-ofmotion. Bilateral knee radiographs showed widespread multiple calcified loose bodies with variable in size, joint space narrowing and osteoporosis. Moreover on bilateral knee magnetic resonance imaging, multiple hypointense and few hyperintense calcified nodules distributed throughout the joint with lobular contours were observed on T1-weighted images and peripheral hypointense central hyperintense multiple nodular lesions with an associated effusion were detected in the same sections of T2-weighted images. The diagnosis was confirmed by pathology following arthroscopic biopsy. SC should be considered in the differential diagnosis of patients presenting with a persistent arthritis in patients with RA.