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Synovial chondromatosis presenting with cervical radiculopathy: a case report
Susumu Chiba1, Norie Koge, Mizuki Oda
1Department of Neurology, School of Medicine, Sapporo Medical University, Sapporo, Japan. chiba@sapmed.ac.jp
Study Design:
A case report is presented.
Objectives:
To report a case of synovial chondromatosis of a cervical facet joint and describe the appearance with magnetic resonance imaging and computed tomography myelography.
Summary Of Background Data:
Synovial chondromatosis is an uncommon disorder characterized by the presence of multiple cartilaginous or osteocartilaginous nodules in the synovium of a joint space. Synovial chondromatosis in the cervical facet joint is rare.
Method:
A 52-year-old woman experienced the sudden onset of severe pain in the dorsal shoulder girdle and in the ulnar side of her right arm and forearm. This refractory pain only responded to an epidural nerve root block. Neurologic examination showed right nerve root signs that ranged from the C7 to Th1 segments of the spinal cord. Radiologic and electrophysiological examinations were carried out.
Result:
A mass was found in the right facet joint between C7 and Th1 with magnetic resonance imaging and computed tomography myelography. These investigations clearly indicated the location, size, and extent of the lesion accompanying the irregularity of the joint and osteolytic change. Somatosensory-evoked potentials with right ulnar nerve stimulation indicated a significant conduction block in the lower right cervical nerve roots. After surgical removal of this lesion, the neurologic symptoms markedly improved. The histopathology diagnosed synovial chondromatosis.
Conclusion:
Synovial chondromatosis should be included in the differential diagnosis of radiculopathies of unknown etiology.