Humans ; Chondromatosis, Synovial/pathology* ; Chondrosarcoma/pathology*

Cartilage and giant cell-related neoplastic lesions originating in the temporomandibular joint region have similar clinical, imaging and pathological manifestations, making the diagnosis of these disorders challenging to varying degrees. Diagnostic findings can influence treatment procedures and a definitive pathological diagnosis is important for the prognosis of these conditions. In this article, we discuss the pathological diagnosis and differentiation of four benign cartilage and giant cell related tumors and tumor-like lesions that occur in the temporomandibular joint, namely synovial chondromatosis, tumoral calcium pyrophosphate deposition disease, pigmented villonodular synovitis and chondroblastoma, taking into account their clinical features and histological manifestations, with a view to providing a basis for clinical management.
Humans ; Temporomandibular Joint/pathology* ; Chondromatosis, Synovial/pathology* ; Synovitis, Pigmented Villonodular/pathology* ; Giant Cells/pathology* ; Cartilage

Adult ; Chondromatosis, Synovial ; pathology ; surgery ; Elbow Joint ; pathology ; surgery ; Humans ; Male

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.
Adult ; Chondromatosis, Synovial/*diagnosis ; Female ; *Hip Joint/pathology/radiography ; Human ; Magnetic Resonance Imaging ; Male

Hip arthroscopy has been useful for resolving unexplained pains of the hip joint, despite its clinical applicability came after many other joints. Surgical indications have been increasing recently. Moreover, additional surgical techniques allow both the anatomy and function to return to its normal state. Recently, the concepts and treatments for extra-articular pathologies, such as deep gluteal syndrome, ischiofemoral impingement, subspinal impingement and iliopsoas impingement as well as classic indication, such as femoroacetabular impingement, acetabular labral tear, loose bodies, and synovial osteochondromatosis have been introduced. We present a diagnosis and treatment for diverse indications of hip arthroscopy, preoperative considerations, surgical technique and postoperative rehabilitation.
Acetabulum ; Arthroscopy* ; Chondromatosis, Synovial ; Diagnosis ; Femoracetabular Impingement ; Hip Joint ; Hip* ; Joints ; Pathology ; Rehabilitation ; Tears

Adult ; Asymptomatic Diseases ; China ; Chondromatosis, Synovial ; diagnostic imaging ; pathology ; physiopathology ; surgery ; Hip Joint ; diagnostic imaging ; pathology ; physiopathology ; surgery ; Hospitals ; Humans ; Male ; Tomography, X-Ray Computed

We have compared the findings of MRI with those of hip arthroscopy in 22 hips in adults with pilinful hip diseases. From March l995 to March 1997. We performed arthroscopy of the hips in symptomatic 22 patients. Fifteen cases were men and the mean average age was 46 years old. Preoperatively, the patients was diagnoseil with careful physical examinations and MR arthrogram or MR1. Among them, acetahular lahrum tears were 13 cases. synovial lesions were 3 cases and avascular necrosis of femoral head were 6 casee. We have examed cartilage softening, indentation or defect of femoral head and acetabulum, acetabular lahrum, loose hodies and synovial lesion hy arthroscopy. Under the arthroscopic guide, We had resected the torn Jahrum in S cases, removed a loose hodies such as synovial chondromatosis in 1 case and excised a synovial pathology in 2 cases. The others had a open arthrotomy in 8 cases. The sensitivity of MRI was 89.5% and its accuracy was 77.3% compared with arthroscopic findings. Average follow-up lengths was 8.6 months and 17(77.3%) of 22 patients were improved clinically. The arthroscopy of the hip is less invasive and a useful investigation for painful hip diseases for labral tears and synovial lesions in adults cspecially when standard MRI fails to prove a exact hip joint pathology, but it may be useless in avascular necrosis of femoral head. Also it is technical demanding and necessary to long-term follow-up.
Acetabulum ; Adult ; Arthroscopy ; Cartilage ; Chondromatosis, Synovial ; Diagnosis* ; Fimbriae Proteins ; Follow-Up Studies ; Head ; Hip Joint ; Hip* ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Necrosis ; Pathology ; Physical Examination