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Primary synovial osteochondromatosis of a subdeltoid bursa.

Kumar A, Aggarwal A, Sahni VK - Indian J Orthop (2010)

Bottom Line: Primary synovial osteochondromatosis (SOC) is known to be intra-articular and wherever it is observed outside a synovial joint, it is associated with the involvement of the nearby joint.Primary SOC has not been reported to involve a subdeltoid bursa.A surgical excision of subdeltoid bursa was done.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopedics, Maharaja Agrasen Hospital, Punjabi Bagh, New Delhi, India.

ABSTRACT
Primary synovial osteochondromatosis (SOC) is known to be intra-articular and wherever it is observed outside a synovial joint, it is associated with the involvement of the nearby joint. Primary SOC has not been reported to involve a subdeltoid bursa. We present a case of a 52-year-old woman having a large number of loose bodies in a large tumor in the subdeltoid bursa. The swelling was first noticed by the patient 2 years back. Plain roentgenogram revealed soft tissue swelling only with no areas of calcification. On MRI, multiple nonosseous loose bodies were visualized in the bursa deep to the deltoid muscle. A surgical excision of subdeltoid bursa was done. A biopsy confirmed it to be cartilaginous loose bodies in synovial lining sugestive of metaplastic transformation of the synovial tissue.

No MeSH data available.


Related in: MedlinePlus

(a) A clinical photograph showing big swelling on the outer aspect of the left shoulder and left upper arm (b) X-ray left shoulder showing a soft tissue swelling in the deltoid region; no point/area of calcification visible in the swelling (c) MRI coronal section through the shoulder joint shows multiple nonossified loose bodies deep into the deltoid muscle with subacromial extension. No loose body below the rotator cuff (d) Another MRI sagittal section through the material of the swelling, showing a large number of loose bodies deep into the deltoid muscle; none is ossified
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Figure 0001: (a) A clinical photograph showing big swelling on the outer aspect of the left shoulder and left upper arm (b) X-ray left shoulder showing a soft tissue swelling in the deltoid region; no point/area of calcification visible in the swelling (c) MRI coronal section through the shoulder joint shows multiple nonossified loose bodies deep into the deltoid muscle with subacromial extension. No loose body below the rotator cuff (d) Another MRI sagittal section through the material of the swelling, showing a large number of loose bodies deep into the deltoid muscle; none is ossified

Mentions: A 52-year-old woman presented with a swelling over the outer aspect of her left shoulder and proximal part of her left arm which she had first noticed 2 years ago. The swelling was obstructing the movements of her affected shoulder and was cosmetically unacceptable [Figure 1a]. She had no history of trauma or fever. Her appetite was not affected, and there had been no weight loss. The globular swelling was painless and measured approximately 8 inches in diameter. No tenderness or warmth, but some pseudofluctuation was observed, along with restriction of all movements except adduction. No abnormality was detected in central nervous, cardiovascular, respiratory, genitourinary, or gastrointestinal systems. She was postmenopausal with no gynecological problem. Routine preoperative investigations (including liver function and renal function tests) were within the normal limit. Serological investigation for rheumatoid arthritis was negative. Plain roentgenogram revealed a soft tissue swelling only [Figure 1b]. There were no areas of calcification.


Primary synovial osteochondromatosis of a subdeltoid bursa.

Kumar A, Aggarwal A, Sahni VK - Indian J Orthop (2010)

(a) A clinical photograph showing big swelling on the outer aspect of the left shoulder and left upper arm (b) X-ray left shoulder showing a soft tissue swelling in the deltoid region; no point/area of calcification visible in the swelling (c) MRI coronal section through the shoulder joint shows multiple nonossified loose bodies deep into the deltoid muscle with subacromial extension. No loose body below the rotator cuff (d) Another MRI sagittal section through the material of the swelling, showing a large number of loose bodies deep into the deltoid muscle; none is ossified
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2822411&req=5

Figure 0001: (a) A clinical photograph showing big swelling on the outer aspect of the left shoulder and left upper arm (b) X-ray left shoulder showing a soft tissue swelling in the deltoid region; no point/area of calcification visible in the swelling (c) MRI coronal section through the shoulder joint shows multiple nonossified loose bodies deep into the deltoid muscle with subacromial extension. No loose body below the rotator cuff (d) Another MRI sagittal section through the material of the swelling, showing a large number of loose bodies deep into the deltoid muscle; none is ossified
Mentions: A 52-year-old woman presented with a swelling over the outer aspect of her left shoulder and proximal part of her left arm which she had first noticed 2 years ago. The swelling was obstructing the movements of her affected shoulder and was cosmetically unacceptable [Figure 1a]. She had no history of trauma or fever. Her appetite was not affected, and there had been no weight loss. The globular swelling was painless and measured approximately 8 inches in diameter. No tenderness or warmth, but some pseudofluctuation was observed, along with restriction of all movements except adduction. No abnormality was detected in central nervous, cardiovascular, respiratory, genitourinary, or gastrointestinal systems. She was postmenopausal with no gynecological problem. Routine preoperative investigations (including liver function and renal function tests) were within the normal limit. Serological investigation for rheumatoid arthritis was negative. Plain roentgenogram revealed a soft tissue swelling only [Figure 1b]. There were no areas of calcification.

Bottom Line: Primary synovial osteochondromatosis (SOC) is known to be intra-articular and wherever it is observed outside a synovial joint, it is associated with the involvement of the nearby joint.Primary SOC has not been reported to involve a subdeltoid bursa.A surgical excision of subdeltoid bursa was done.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopedics, Maharaja Agrasen Hospital, Punjabi Bagh, New Delhi, India.

ABSTRACT
Primary synovial osteochondromatosis (SOC) is known to be intra-articular and wherever it is observed outside a synovial joint, it is associated with the involvement of the nearby joint. Primary SOC has not been reported to involve a subdeltoid bursa. We present a case of a 52-year-old woman having a large number of loose bodies in a large tumor in the subdeltoid bursa. The swelling was first noticed by the patient 2 years back. Plain roentgenogram revealed soft tissue swelling only with no areas of calcification. On MRI, multiple nonosseous loose bodies were visualized in the bursa deep to the deltoid muscle. A surgical excision of subdeltoid bursa was done. A biopsy confirmed it to be cartilaginous loose bodies in synovial lining sugestive of metaplastic transformation of the synovial tissue.

No MeSH data available.


Related in: MedlinePlus