Secondary Synovial Chondromatosis of the Shoulder Associated with Rotator Cuff Tear: Diagnostic Challenge and Arthroscopic Management - A Case Report.

INTRODUCTION: Synovial chondromatosis (SC) is a rare benign disorder of the synovium characterized by cartilaginous metaplasia and intra-articular loose body formation. It commonly affects large joints such as the knee, whereas shoulder involvement is extremely rare and is often misdiagnosed. We present a rare case of shoulder SC in an elderly female, highlighting the diagnostic challenges and arthroscopic surgical management.

CASE REPORT: A 64-year-old female presented with an alleged history of a fall on her outstretched hand 18 months back. Following the trauma, the patient complained of right shoulder pain and later restriction of movement. Examination revealed restriction of movement with crepitus and positive impingement signs. Radiographs were normal. Magnetic resonance imaging (MRI) revealed multiple intra-articular loose bodies with a supraspinatus tear. She underwent arthroscopic rotator cuff repair, loose body removal, and synovectomy. Histopathology confirmed SC. Post-operative rehabilitation led to satisfactory recovery.

CONCLUSION: This case highlights the occurrence or incidence of SC in long-standing rotator cuff tears and also emphasizes the importance of considering SC in the differential diagnosis of chronic shoulder pain, especially when radiographs are inconclusive. MRI plays a pivotal role in early diagnosis, and arthroscopic surgery provides effective management with excellent outcomes.