Synovial chondromatosis of suprapatellar bursa in a case of rheumatoid arthritis

Abstract

A 70-year-old female, hypertensive and diabetic for 15 years, presented with symmetrical inflammatory polyarthritis of the small and large joints of the upper and lower limbs of 8 months duration. She had multiple tender and swollen joints and painful, restricted movement of the left knee. The ESR was elevated, and RF was negative. She was diagnosed as seronegative RA and was initiated on oral MTX and low-dose CS. She also received IA CS in the left knee in view of the severe debilitating pain. At 2 months follow-up, she continued to have left knee pain with tenderness and had no other tender or swollen joints. Radiographs of the knees showed bilateral grade three OA with chondromatosis of the left suprapatellar bursa (Fig. 1A and B, arrow). Surgical removal of cartilaginous bodies while performing a total knee arthroplasty is planned at later date. Fig. 1 Synovial chondromatosis Anteroposterior (A) and lateral (B) radiographic views of knees, showing synovial osteochondromatosis of left suprapatellar bursa (arrowed). Synovial chondromatosis is a rare, tumour-like, benign lesion of the synovium, which may occur in the synovial membrane of a joint, bursa or tendon sheath. It usually presents unilaterally in large joints. The knee is the joint most commonly involved, but chondromatosis can also manifest in other joints, such as the shoulder, elbow, hip and ankle [1]. It is uncommon in RA, and only a few cases have been reported. Funding: No specific funding was received from any funding bodies in the public, commercial or not for-profit sectors to carry out the work described in this manuscript. Disclosure statement: The authors have declared no conflicts of interest.