Primary Synovial Osteochondromatosis of Knee (Reichel-Jones-Henderson Syndrome)

contributed by: Dr. Zohaib Hussain
Loading

Loading

Findings
Radiological Evaluation
Plain X-ray Radiograph: Plain X-ray Radiograph of right knee AP and Lateral views reveal multiple calcifications in and around the right knee joint including in the suprapatellar region, few with typical ring-and-arc appearance of chondroid tissue. These features are suggestive of multiple intra articular loose bodies.

Magnetic Resonance (MR) Imaging: Multiplanar PD (proton density weighted) and PDFS (proton density fat saturated) MR images reveal multiple hetero-intense nodular lesions with evidence of effusion in the knee joint cavity and supra-patellar recess. Few of the nodules show internal areas of high PD and PDFS signal intensity, suggestive of lack of mineralization. There is also surrounding myofascial edema.

Sagittal & Axial T1W fat saturated post contrast images reveal synovial enhancement of the knee joint with mild peripheral enhancement of the intra-articular nodules, typical pattern of hyaline cartilage enhancement. There is also evidence of synovitis.
Diagnosis
Based on clinical history with multi-modality imaging findings, a diagnosis of primary synovial osteochondromatosis of the right knee joint (transitional stage as per Milgram) was made. The imaging findings are pathognomonic. There is no evidence of any bone erosions, ruling out malignant transformation. There is also evidence of joint effusion and synovitis.
Dr. Zohaib Hussain MD is a Consultant Radiologist from Lakhimpur with experience of 3-5 years post-graduated from Gauhati Medical College, Guwahati. Specialized in Reporting of X-RAYS , CT-SCAN , MRI , MAMMOGRAM , NUCLEAR-MEDICINE cases with expertise in Neuro-imaging , Spine-imaging , Pediatrics-imaging , Trauma , Stroke-imaging
Are you looking for Paid consultation or Second Opinion from Expert Radiologist ?
Consult Dr. Zohaib Hussain
Page Visits : 65