60 year old with knee pain.
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Knee radiographs show multiple rounded osseous loose bodies of similar size in the supra patellar knee joint. 3 compartment degenerative changes (DJD) including joint space narrowing, subchondral sclerosis, and marginal osteophytes are present.
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Diagnosis: Primary synovial osteochondromatosis (PSO)
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In PSO, benign synovial metaplasia gives rise to chondral and osseous loose bodies of similar size; secondary degenerative changes then occur. In secondary synovial osteochondromatosis, DJD, AVN, or ostechondral defects lead to loose bodies of varying size, more common. Loose bodies can varying size and degree of calcification and can occur in joint spaces, bursa, tendon sheaths and synovium. Erosions may occur. -------------------------------------------
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