Synovial chondromatosis in an elite cyclist: a case report.
Primary synovial chondromatosis is a rare disorder that can present as chronic hip and groin pain. It is characterized by formation of osteocartilaginous nodules arising from the synovium. We report the first case, to our knowledge, of an Olympic-caliber cyclist, in her mid thirties, with primary synovial chondromatosis of the left hip. Clinical examination showed decreased internal rotation, external rotation, forward flexion, and abduction of the left hip. A radiograph of the left hip showed slight hip-joint narrowing centrally. A magnetic resonance imaging arthrogram showed a small anterior labral tear and innumerable small intermediate-intensity filling defects situated diffusely within the joint fluid. Fluoroscopically guided injection of the left hip with local anesthetic and cortisone produced temporary pain relief. Conservative treatment was marginally helpful. Results of a rheumatology workup were unremarkable. Arthroscopic removal of loose bodies and synovectomy were performed. The diagnosis of primary synovial chondromatosis was confirmed by histologic examination. At the 17-month follow-up, our patient was essentially pain free and had returned to her previous athletic activities.
Doward
David A
DA
Department of Orthopaedic Surgery, Division of Physical Medicine and Rehabilitation, Stanford University School of Medicine, Stanford, CA, USA. dadoward@yahoo.com
Troxell
Megan L
ML
Fredericson
Michael
M
D000328:Adult; D001182:Arthroscopy; D001642:Bicycling / Q000293:injuries; D015838:Chondromatosis, Synovial / Q000175:diagnosis* / Q000628:therapy*; D003131:Combined Modality Therapy; D003937:Diagnosis, Differential; D003952:Diagnostic Imaging; D005260:Female; D006621:Hip Joint; D006801:Humans; D010147:Pain Measurement