# Recurrent synovial chondromatosis in the hand leading to second ray amputation: A case report

## TL;DR

This case report describes a rare instance of synovial chondromatosis in the hand of a young woman, which led to amputation due to recurring issues and challenges in diagnosis and treatment.

## Contribution

The report highlights the rare occurrence of synovial chondromatosis in the hand and suggests that earlier aggressive treatment may improve outcomes.

## Key findings

- Synovial chondromatosis in the hand is uncommon and difficult to diagnose.
- Multiple surgeries may not prevent recurrence or functional impairment.
- Earlier aggressive intervention or amputation could potentially improve patient outcomes.

## Abstract

Synovial chondromatosis is a rare, benign metaplasia of the synovium characterized by the formation of cartilaginous nodules. This condition can lead to joint stiffness, pain, and damage. It is most common in the knee but has been described in various joints, including the hand. Due to its low prevalence and nonspecific symptoms, delayed diagnosis may lead to complications such as local invasion, pain, osteoarthritis, and, rarely, malignant transformation. Surgical intervention is often indicated after conservative management fails.

This report describes the complex case of synovial chondromatosis of the second metacarpophalangeal (MCP) joint in an 18-year-old female. Multiple surgical interventions culminated in amputation of her second ray for definitive management.

This case underscores the complexities of diagnosing and managing synovial chondromatosis, particularly in rare locations like the hand. Despite radiographic and pathological evidence, a definitive diagnosis was delayed, contributing to prolonged morbidity. The aggressive and recurring nature of this case highlights the need to consider synovial chondromatosis in refractory hand and finger joint pain, regardless of patient age or gender. Questions remain about whether earlier aggressive intervention could reduce recurrence or if earlier amputation could improve outcomes.

This case highlights the challenges of diagnosing and managing recurrent synovial chondromatosis in the hand. Early recognition and aggressive intervention may prevent prolonged morbidity and functional impairment. Further research is needed to determine whether earlier amputation could improve outcomes in refractory cases.

•Synovial chondromatosis of the hand is uncommon and challenging to diagnose.•There is risk of recurrence and functional impairment even after multiple surgeries.•Earlier aggressive surgery or amputation could improve patient outcomes.

Synovial chondromatosis of the hand is uncommon and challenging to diagnose.

There is risk of recurrence and functional impairment even after multiple surgeries.

Earlier aggressive surgery or amputation could improve patient outcomes.