Summary

To reflect the misdiagnosis reasons of some cases of subacromial space synovial chondromatosis and evaluate therapeutic effect of arthroscopic treatment of subacromial space synovial chondromatosis.

Abstract

Methods: From September 2013 to 2014 December, 6 patients with subacromial synovial chondromatosis were treated. There were 1 males and 3 female, aged 28-62 years with an average of 41.6 years old. All patients had unilateral involvement(4 cases of left shoulder, right shoulder in 2 cases); The average time from initial diagnosis to operation was 12.5 months (3-34 months). The main clinical symptoms were shoulder pain and significant activities limited. Before the operation, the UCLA score of the shoulder joint was average 24 + 6.9, and the Constant-Murley score was 77 + 8.2. The 6 patients admitted to hospital were according to X-ray that showed "shoulder articular calcified tendinitis". In preoperative discussion or intraoperative exploration, We found misdiagnosis. They intraoperative diagnosis is subacromial space synovial chondromatosis. All patients were treated by arthroscopic surgery, including arthroscopic inspection, removal of free body and diseased synovium and treatment of degenerative joint diseases.

Results

combined with the previous Misdiagnosis experience, repeated studies imaging data and physical examination, and summarized the diagnostic features of subacromial space synovial chondromatosis. All patients were followed up for an average of 13 months (9~24 months). There is no postoperative pain symptom, UCLA shoulder scoring of the affected side was 34 + 1.6 and Constant-Murley score was 92 + 6.8. Compared with the preoperative, it had significant difference (P < 0.05). The joint activity is improved. There is no recurrence in our followed up.

Conclusion

Subacromial synovial chondromatosis has some features, need to be carefully identified, to avoid misdiagnosis. Arthroscopy is an effective modality for the treatment of Subacromial synovial chondromatosis with advantages of minimal invasion, exhaustive excision of the diseased synovium and quick recovery.