Imaging Characteristics of Tenosynovial and Bursal Chondromatosis

摘要

Objectives: Our purpose was to identify imaging characteristics of tenosynovial and bursal chondromatosis. Materials and methods: We retrospectively reviewed 25 pathologically confirmed cases of tenosynovial (n=21) or bursal chondromatosis (n=4). Patient demographics and clinical presentation were reviewed. Imaging was evaluated by two musculoskeletal radiologists with agreement by consensus, including radiography (n=21), bone scintigraphy (n=1), angiography (n=1), ultrasonography (n=1), CT (n=8), and MR (n=8). Imaging was evaluated for lesion location/shape, presence/number of calcifications, evidence of bone involvement, and intrinsic characteristics on ultrasonography/CT/MR. Results Average patient age was 44 years (range 7 to 75 years) with a mild male predilection (56%). A slowly increasing soft tissue mass was the most common clinical presentation (53%). Lesion locations included the foot (n=8), hand (n=6), shoulder (n=3) knee (n=2), ankle (n=2) and one each in the upper arm forearm, wrist, and cervical spine. All lesions were located in a known tenosynovial (21 cases, 84%) or bursal (four cases, 16%) location. All cases of bursal chondromatosis were round/oval in shape. Tenosynovial lesions were fusiform (65%) or round/oval (35%). Radiographs commonly showed a soft tissue mass (86%) and calcification (90%). Calcifications were predominantly chondroid (79%) or osteoid (11%) in character with >10 calcified bodies in 48%. CT detected calcifications in all cases. The intrinsic characteristics of the nonmineralized component showed low attenuation on CT (75%), high signal intensity on T2-weighted MR (76%) and a peripheral/ septal contrast enhancement pattern (100%). Conclusions Imaging of tenosynovial and bursal chondromatosis is often characteristic with identification of multiple osteochondral calcifications (90% by radiographs; 100% by CT).