title: Imaging characteristics of tenosynovial and bursal chondromatosis.
abstract: OBJECTIVE
  Our purpose was to identify imaging characteristics of tenosynovial and bursal chondromatosis.
  
  
  METHODS
  We retrospectively reviewed 25 pathologically confirmed cases of tenosynovial (n = 21) or bursal chondromatosis (n = 4). Patient demographics and clinical presentation were reviewed. Imaging was evaluated by two musculoskeletal radiologists with agreement by consensus, including radiography (n = 21), bone scintigraphy (n = 1), angiography (n = 1), ultrasonography (n = 1), CT (n = 8), and MR (n = 8). Imaging was evaluated for lesion location/shape, presence/number of calcifications, evidence of bone involvement, and intrinsic characteristics on ultrasonography/CT/MR.
  
  
  RESULTS
  Average patient age was 44 years (range 7 to 75 years) with a mild male predilection (56%). A slowly increasing soft tissue mass was the most common clinical presentation (53%). Lesion locations included the foot (n = 8), hand (n = 6), shoulder (n = 3), knee (n = 2), ankle (n = 2) and one each in the upper arm, forearm, wrist, and cervical spine. All lesions were located in a known tenosynovial (21 cases, 84%) or bursal (four cases, 16%) location. All cases of bursal chondromatosis were round/oval in shape. Tenosynovial lesions were fusiform (65%) or round/oval (35%). Radiographs commonly showed a soft tissue mass (86%) and calcification (90%). Calcifications were predominantly chondroid (79%) or osteoid (11%) in character with >10 calcified bodies in 48%. CT detected calcifications in all cases. The intrinsic characteristics of the nonmineralized component showed low attenuation on CT (75%), high signal intensity on T2-weighted MR (76%) and a peripheral/septal contrast enhancement pattern (100%).
  
  
  CONCLUSIONS
  Imaging of tenosynovial and bursal chondromatosis is often characteristic with identification of multiple osteochondral calcifications (90% by radiographs; 100% by CT). CT and MR also revealed typical intrinsic characteristics of chondroid tissue and lesion location in a known tendon sheath or bursa.
authors: Department of Radiology and Nuclear Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA. ewalker@hmc.psu.edu
authors: Eric A
authors: EA
authors: Walker
authors: Mark D
authors: MD
authors: Murphey
authors: John F
authors: JF
authors: Fetsch
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002061:Bursa, Synovial / Q000000981:diagnostic imaging / Q000473:pathology; D002648:Child; D015838:Chondromatosis, Synovial / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013583:Synovial Membrane / Q000000981:diagnostic imaging / Q000473:pathology; D013710:Tendons / Q000000981:diagnostic imaging / Q000473:pathology; D014057:Tomography, X-Ray Computed; D055815:Young Adult