Radiographs were analysed in terms of the presence of 1) juxta-articular calcified and/ or ossified bodies, 2) osteophytes, 3) bone erosion, 4) juxta-articular osteopenia, and 5) joint space narrowing.įor MR images, attention was focused on 1) the configuration of intra-articular bodies, 2) bone erosion, 3) synovial thickening, 4) conglomeration of the intra-articular bodies, and 5) extra-articular extension. Hip radiographs and MR images were evaluated by two experienced musculoskeletal radiologists, who reached a consensus. Section thickness was 5-6 mm and section gap, 1-2 mm. Using a field of view of 18-38 cm, two signals were acquired. Spin-echo T1-weighted (400-700/10-40 ) and fast spin-echo T2-weighted (1500-5000/70-112 ) or turbo spin-echo T2-weighted MR images (3500-4500/80-95 ) were obtained in the axial, coronal, and sagittal planes. For the latter, a 1.5-T (Signa General Electric Medical Systems, Milwaukee, Wis., U.S.A.) or a 1.0-T imager (Magnetom Impact Siemens, Erlangen, Germany) was used. The patients underwent hip radiography and MR imaging. Clinical records, pathologic results, and the radiologic findings were reviewed. The clinical symptoms were hip pain in 14 patients and a painful inguinal mass in one the duration of these ranged from 6 months to 8 (mean, 3.9) years. Previously described criteria ( 2, 3, 5, 17), including the greater number and uniformity in size of intra-articular bodies, and the absence of significant arthritic change, were used to differentiate between idiopathic and secondary synovial osteochondromatosis. There are scattered reports of idiopathic synovial osteochondromatosis of the hip ( 13 - 16), but to more fully characterize the radiologic findings of this condition, with emphasis on the appearance at MRI, the MRI findings of 15 patients were retrospectively analysed.įifteen patients with histopathologically proven synovial osteochondromatosis of the hip were involved in this study. Synovial osteochondromatosis that develops within a bursa overlying an osteochondroma may simulate malignant transformation of the osteochondroma ( 12). The radiologic appearance of idiopathic synovial osteochondromatosis depends on the stage of the disease and the extent of calcification or ossification of the cartilaginous nodule ( 3, 5, 11). Currently accepted surgical treatment involves the removal of any free intra-articular bodies and complete resection of the involved synovium, although local recurrence is not uncommon ( 1 - 5, 13, 15). The condition is usually progressive and leads to early osteoarthritis. The age range of affected patients is wide, but most present in the fourth or fifth decade of life men are affected two to four more times frequently than women ( 3, 11). Patients usually present with pain, swelling, and restricted movement, symptoms which often progress slowly for several years ( 3). The knee is the most commonly affected joint, followed by the elbow, hip, and shoulder, although any other joint may be involved ( 3 - 15). Idiopathic synovial osteochondromatosis is an uncommon benign monoarticular disorder of unknown cause characterized by proliferation and metaplastic transformation of the synovium, where there is cartilage formation ( 1 - 3).
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