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Idiopathic synovial osteochondromatosis of the hip: radiographic and MR appearances in 15 patients.

Kim SH, Hong SJ, Park JS, Cho JM, Kim EY, Ahn JM, Park YS - Korean J Radiol (2002 Oct-Dec)

Bottom Line: Synovial thickening was present in 13 patients (87%), bone erosion in 11 (73%), conglomeration of the intra-articular bodies in 11 (73%), and an extra-articular herniation sac in six (40%).MR imaging depicted intra-articular bodies of focal low signal intensity at all pulse sequences, with areas of iso-intensity at T1WI and hyperintensity at T2WI.In addition, the presence of an extra-articular herniation sac was not uncommon.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Kangnamgu, Seoul, Korea.

ABSTRACT

Objective: To evaluate the radiographic and MR appearance of idiopathic synovial osteochondromatosis of the hip.

Materials and methods: Radiographs and MR images of 15 patients with idiopathic synovial osteochondromatosis of the hip were assessed. The former were analysed in terms of the presence of 1) juxta-articular calcified and/ or ossified bodies, 2) osteophytes, 3) bone erosion, 4) juxta-articular osteopenia, and 5) joint space narrowing, while for the latter, analysis focused on 1) the configuration of intra-articular bodies, 2) bone erosion, 3) synovial thickening, 4) conglomeration of intra-articular bodies, and 5) extra-articular extension.

Results: At hip radiography, juxta-articular calcified and/ or ossified bodies were seen in 12 of the 15 patients (80%), bone erosion in eight (53%), osteophytes in seven (47%), juxta-articular osteopenia in five (33%) and joint space narrowing in five (33%). In eight patients (53%), MR imaging depicted intra-articular bodies of focal low signal intensity at all pulse sequences, and areas of isointensity at T1WI and hyperintensity at T2WI. In three (20%), intra-articular bodies of focal low signal intensity and areas of hyperintensity at all pulse sequences were observed, with areas of iso-intensity at T1WI and hyperintensity at T2WI, while in four (27%), intra-articular bodies of only focal low signal intensity at all pulse sequences were apparent. Synovial thickening was present in 13 patients (87%), bone erosion in 11 (73%), conglomeration of the intra-articular bodies in 11 (73%), and an extra-articular herniation sac in six (40%).

Conclusion: The most common radiographic finding of synovial osteochondromatosis of the hip was the presence of juxta-articular calcified and/ or ossified bodies. MR imaging depicted intra-articular bodies of focal low signal intensity at all pulse sequences, with areas of iso-intensity at T1WI and hyperintensity at T2WI. In addition, the presence of an extra-articular herniation sac was not uncommon.

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A 52-year-old woman with idiopathic synovial osteochondromatosis of the left hip.A. Anteoposterior radiograph of the left hip depicts juxta-articular calicified and/ or ossified bodies (arrowheads), and an osteophyte (straight arrow). Note that superior to the iliopubic line, a calcified and/or ossified body (curved arrow) is also present, suggesting intrapelvic extension of the lesion.B. T1-weighted coronal MR image of the same patient shows an intra-articular lesion of low signal intensity (curved arrows), signal intensity which corresponds to an area of fat (straight arrow), and a conglomerated lesion (open arrow). Note that intrapelvic extension of the iliopsoas bursa has occurred (arrowheads).C. T2-weighted image, obtained at the same level as in B, shows intra-articular bodies of focal low signal intensity (curved arrows), and a conglomerated lesion (straight arrow). Note that intrapelvic extension of the iliopsoas bursa is again apparent (arrowheads).
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Figure 1: A 52-year-old woman with idiopathic synovial osteochondromatosis of the left hip.A. Anteoposterior radiograph of the left hip depicts juxta-articular calicified and/ or ossified bodies (arrowheads), and an osteophyte (straight arrow). Note that superior to the iliopubic line, a calcified and/or ossified body (curved arrow) is also present, suggesting intrapelvic extension of the lesion.B. T1-weighted coronal MR image of the same patient shows an intra-articular lesion of low signal intensity (curved arrows), signal intensity which corresponds to an area of fat (straight arrow), and a conglomerated lesion (open arrow). Note that intrapelvic extension of the iliopsoas bursa has occurred (arrowheads).C. T2-weighted image, obtained at the same level as in B, shows intra-articular bodies of focal low signal intensity (curved arrows), and a conglomerated lesion (straight arrow). Note that intrapelvic extension of the iliopsoas bursa is again apparent (arrowheads).

Mentions: Idiopathic synovial osteochondromatosis was present in the right hip in eight patients, and in the left, in seven. At hip radiography, juxta-articular calcified and/ or ossified bodies were seen in 12 patients (80%) (Figs. 1A, 2A), bone erosion in eight (53%) (Fig. 3A), osteophytes in seven (47%) (Figs. 1A, 2A), juxta-articular osteopenia in five (33%) (Fig. 4A), and joint space narrowing in five (33%) (Fig. 4A). In one patient with bone erosion, this was extensive and circumferential, with scalloping of the femoral neck (Fig. 3).


Idiopathic synovial osteochondromatosis of the hip: radiographic and MR appearances in 15 patients.

Kim SH, Hong SJ, Park JS, Cho JM, Kim EY, Ahn JM, Park YS - Korean J Radiol (2002 Oct-Dec)

A 52-year-old woman with idiopathic synovial osteochondromatosis of the left hip.A. Anteoposterior radiograph of the left hip depicts juxta-articular calicified and/ or ossified bodies (arrowheads), and an osteophyte (straight arrow). Note that superior to the iliopubic line, a calcified and/or ossified body (curved arrow) is also present, suggesting intrapelvic extension of the lesion.B. T1-weighted coronal MR image of the same patient shows an intra-articular lesion of low signal intensity (curved arrows), signal intensity which corresponds to an area of fat (straight arrow), and a conglomerated lesion (open arrow). Note that intrapelvic extension of the iliopsoas bursa has occurred (arrowheads).C. T2-weighted image, obtained at the same level as in B, shows intra-articular bodies of focal low signal intensity (curved arrows), and a conglomerated lesion (straight arrow). Note that intrapelvic extension of the iliopsoas bursa is again apparent (arrowheads).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2713848&req=5

Figure 1: A 52-year-old woman with idiopathic synovial osteochondromatosis of the left hip.A. Anteoposterior radiograph of the left hip depicts juxta-articular calicified and/ or ossified bodies (arrowheads), and an osteophyte (straight arrow). Note that superior to the iliopubic line, a calcified and/or ossified body (curved arrow) is also present, suggesting intrapelvic extension of the lesion.B. T1-weighted coronal MR image of the same patient shows an intra-articular lesion of low signal intensity (curved arrows), signal intensity which corresponds to an area of fat (straight arrow), and a conglomerated lesion (open arrow). Note that intrapelvic extension of the iliopsoas bursa has occurred (arrowheads).C. T2-weighted image, obtained at the same level as in B, shows intra-articular bodies of focal low signal intensity (curved arrows), and a conglomerated lesion (straight arrow). Note that intrapelvic extension of the iliopsoas bursa is again apparent (arrowheads).
Mentions: Idiopathic synovial osteochondromatosis was present in the right hip in eight patients, and in the left, in seven. At hip radiography, juxta-articular calcified and/ or ossified bodies were seen in 12 patients (80%) (Figs. 1A, 2A), bone erosion in eight (53%) (Fig. 3A), osteophytes in seven (47%) (Figs. 1A, 2A), juxta-articular osteopenia in five (33%) (Fig. 4A), and joint space narrowing in five (33%) (Fig. 4A). In one patient with bone erosion, this was extensive and circumferential, with scalloping of the femoral neck (Fig. 3).

Bottom Line: Synovial thickening was present in 13 patients (87%), bone erosion in 11 (73%), conglomeration of the intra-articular bodies in 11 (73%), and an extra-articular herniation sac in six (40%).MR imaging depicted intra-articular bodies of focal low signal intensity at all pulse sequences, with areas of iso-intensity at T1WI and hyperintensity at T2WI.In addition, the presence of an extra-articular herniation sac was not uncommon.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Kangnamgu, Seoul, Korea.

ABSTRACT

Objective: To evaluate the radiographic and MR appearance of idiopathic synovial osteochondromatosis of the hip.

Materials and methods: Radiographs and MR images of 15 patients with idiopathic synovial osteochondromatosis of the hip were assessed. The former were analysed in terms of the presence of 1) juxta-articular calcified and/ or ossified bodies, 2) osteophytes, 3) bone erosion, 4) juxta-articular osteopenia, and 5) joint space narrowing, while for the latter, analysis focused on 1) the configuration of intra-articular bodies, 2) bone erosion, 3) synovial thickening, 4) conglomeration of intra-articular bodies, and 5) extra-articular extension.

Results: At hip radiography, juxta-articular calcified and/ or ossified bodies were seen in 12 of the 15 patients (80%), bone erosion in eight (53%), osteophytes in seven (47%), juxta-articular osteopenia in five (33%) and joint space narrowing in five (33%). In eight patients (53%), MR imaging depicted intra-articular bodies of focal low signal intensity at all pulse sequences, and areas of isointensity at T1WI and hyperintensity at T2WI. In three (20%), intra-articular bodies of focal low signal intensity and areas of hyperintensity at all pulse sequences were observed, with areas of iso-intensity at T1WI and hyperintensity at T2WI, while in four (27%), intra-articular bodies of only focal low signal intensity at all pulse sequences were apparent. Synovial thickening was present in 13 patients (87%), bone erosion in 11 (73%), conglomeration of the intra-articular bodies in 11 (73%), and an extra-articular herniation sac in six (40%).

Conclusion: The most common radiographic finding of synovial osteochondromatosis of the hip was the presence of juxta-articular calcified and/ or ossified bodies. MR imaging depicted intra-articular bodies of focal low signal intensity at all pulse sequences, with areas of iso-intensity at T1WI and hyperintensity at T2WI. In addition, the presence of an extra-articular herniation sac was not uncommon.

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Related in: MedlinePlus