Primary synovial osteochondromatosis of the hand and wrist - Report of a series of 21 cases and literature review

Objectives. To define the characteristics of synovial osteochondromatosis o f the hand and wrist. Patients and methods. Retrospective study of 21 patie nts. including 11 with intraarticular and 10 with tenosynovial disease. Cas es secondary to degenerative joint disease were excluded. Surgery consisted in removal of the osteocartilaginous bodies and of the adjacent synovial m embrane. Mean follow-up was seven years (range, three to 18 years). The rel evant literature was reviewed in part. Results. Recurrence was seen in four patients and was multiple in two of these four. Most recurrences occurred within five to ten years after surgery. All four patients with recurrences had intraarticular disease. No cases of malignant transformation were seen. The characteristics of synovial osteochondromatosis at the hand and wrist are reviewed. Conclusion. Detailed preoperative investigations including co mputed arthrotomography and magnetic resonance imaging should be performed to increase the likelihood of complete excision.