Synovial Chondromatosis: A Narrative Review of Current Evidence on Diagnosis, Differential Diagnosis, and Management.

Background and Objectives: Synovial chondromatosis is a rare benign disease characterized by chondral metaplasia of the synovial membrane and the formation of intra-articular loose bodies. Although usually benign, delayed diagnosis may lead to progressive joint damage, recurrence, and, rarely, malignant transformation. Materials and Methods: A narrative review of the literature was conducted using the PubMed/MEDLINE database, focusing on studies published between January 2010 and December 2025. Eligible studies addressed the classification, epidemiology, clinical presentation, imaging findings, histopathology, differential diagnosis, treatment, recurrence, and prognosis of synovial chondromatosis. Results: Synovial chondromatosis most commonly affects large joints. Plain radiographs may show calcified loose bodies, whereas MRI is essential for detecting early non-calcified disease and assessing synovial involvement. Treatment depends on symptoms, disease extent, joint damage, and recurrence risk. Surgical removal of loose bodies with synovectomy remains the mainstay of treatment, while arthroplasty may be considered in advanced degenerative disease. Conclusions: This review provides an updated and clinically oriented synthesis of synovial chondromatosis, emphasizing early recognition, multidisciplinary diagnostic assessment, appropriate surgical management, and vigilant follow-up. Particular attention should be paid to recurrent disease and aggressive clinical or radiological features suggestive of malignant transformation.