Synovial Chondromatosis of Hip: A Rare Cause of Hip Pain in a Young Adult
Year: 2026
Type: article
Abstract: Introduction: Synovial chondromatosis is a rare, benign disorder of the synovium characterized by metaplastic formation of multiple cartilaginous loose bodies. Hip involvement is uncommon and may present with non-specific symptoms, making a high index of suspicion important for early diagnosis. Case Report: A 28-year-old male presented with a 6-week history of right groin pain, which was worse on standing and walking. Examination revealed anterior hip tenderness and terminally restricted, painful internal and external rotation in flexion. Radiographs demonstrated two radiolucent areas in the femoral neck with femoral-neck erosion, narrowing, and lytic changes. Blood investigations, including inflammatory markers, were normal. As symptoms persisted despite symptomatic treatment, magnetic resonance imaging was performed and demonstrated synovitis and joint effusion. Differential diagnoses included non-specific synovitis, Koch's synovitis, synovial chondromatosis and pigmented villonodular synovitis. Right hip arthroscopy and synovial biopsy were performed. Arthroscopy demonstrated synovitis, effusion, and multiple chondral loose bodies. Histopathology confirmed synovial chondromatosis. Because of the extensive synovial involvement and numerous loose bodies, safe surgical dislocation (SSD) was performed 6 weeks later for extensive loose-body removal and near-total synovectomy. The articular cartilage of the femoral head and acetabulum was intact and pristine. A single post-operative dose of radiotherapy was administered as an adjunct to reduce the risk of recurrence. At 4-year follow-up, the patient remained asymptomatic, with no clinical or radiographic evidence of particulence, avascular necrosis, or secondary osteoarthritis. Conclusion: A high index of suspicion for synovial chondromatosis in a young patient with persistent hip pain can facilitate early diagnosis and treatment. In this case, staged arthroscopy followed by SSD enabled extensive removal of loose bodies and synovectomy, with successful preservation of the native hip at 4 years. This case does not establish superiority of this approach over other contemporary treatment options.
Institution: Star Hospitals
Language: English
Subfield: Rheumatology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $250
OpenAlex ID: W7225585082