Subscribe to RSS
Extensive Synovial Chondromatosis Involving All Flexor Tendons in the Tarsal Tunnel: A Case Report[*]Article in several languages: português | English
01 July 2017
13 July 2017
01 March 2019 (online)
Synovial chondromatosis is a rare condition characterized by benign chondrogenic meta- plasia of extra-articular synovial tissue. It usually affects a single tendon sheath of the hand or foot. This report describes a rare case with extensive synovial chondromatosis affecting all flexor tendons in the tarsal tunnel, its radiological features, surgical treatment, and clinical outcome. The authors present a unique case of extensive synovial chondromatosis in a 48-year-old male involving the tendon sheaths of the flexor hallucis longus, flexor digitorum longus, and posterior tibialis tendons, at the level of the tarsal tunnel, with extension into the plantar aspect of the foot. The patient initially presented with symptoms of tarsal tunnel compression and was found to have a 4-cm mass in the posteromedial aspect of the ankle. The presumptive diagnosis of synovial chondromatosis was made based on radiographic and magnetic resonance imaging evidence. The patient underwent surgical resection of the tumor, as well as tarsal tunnel release and gastrocnemius recession. The diagnosis was confirmed postoperatively by surgical histopathology. The postoperative course of the patient was uncomplicated and his tarsal tunnel symptoms resolved. This represents a case of extensive synovial chondromatosis involving all flexor tendons in the tarsal tunnel that was correctly diagnosed by clinical and imaging findings, which required early surgical resection to avoid long-term neurovascular complications.
Keywordssynovial chondromatosis/diagnostic imaging - synovial chondromatosis/surgery - synovial chondromatosis/diagnosis - synovial chondromatosis/pathology - synovitis
* Study conducted at Division of Orthopaedic Surgery, Department of Surgery, University of Alabama at Birmingham (UAB), Birmingham, United States. Published by Elsevier Editora Ltda. © 2018 Sociedade Brasileira de Ortopedia e Traumatologia.
- 1 Lasmar NP, Vieira RB, Rosa JdeO, Lasmar RCP, Scarpa AC. SYNOVIAL CHONDROMATOSIS. Rev Bras Ortop 2015; 45 (05) 490-2
- 2 Walker EA, Murphey MD, Fetsch JF. Imaging characteristics of tenosynovial and bursal chondromatosis. Skeletal Radiol 2011; 40 (03) 317-25
- 3 Fetsch JF, Vinh TN, Remotti F, Walker EA, Murphey MD, Sweet DE. Tenosynovial (extraarticular) chondromatosis: an analysis of 37 cases of an underrecognized clinicopathologic entity with a strong predilection for the hands and feet and a high local recurrence rate. Am J Surg Pathol 2003; 27 (09) 1260-8
- 4 Sugimoto K, Iwai M, Kawate K, Yajima H, Takakura Y. Tenosynovial osteochondromatosis of the tarsal tunnel. Skeletal Radiol 2003; 32 (02) 99-102
- 5 Lui TH. Tenosynovial osteochondromatosis of the flexor hallucis longus tendon treated by tendoscopy. J Foot Ankle Surg 2015; 54 (04) 758-64
- 6 Thomsen TW, Hogrefe CP, Hall MM, Amendola A. Tenosynovial osteochondromatosis of the flexor hallucis longus in a division I tennis player. Clin J Sport Med 2015; 25 (06) e74-6
- 7 Winters NI, Thomson AB, Flores RR, Jordanov MI. Tenosynovial chondromatosis of the flexor hallucis longus in a 17-year-old girl. Pediatr Radiol 2015; 45 (12) 1874-7