case_images: PMC5447904_01
case_images: PMC5447904_02
case_images: Images of a 65-year-old female with extra-articular tenosynovial chondromatosis. The plain radiographs of the index finger of the right hand show irregularity of the cortex at the distal end of the proximal phalanx and of the second metacarpal bone (a: anteroposterior; left, oblique; middle, lateral; right). MRIs (b-j) show multinodular lesions around the proximal interphalangeal joint (e-g) and metacarpophalangeal joint (h-j) levels with homogeneous low signal intensity on the T1-weighted images (b, e, and h), and heterogeneous low to high signal intensity on the T2-weighted images (c, f, and i) with fat-suppression (d, g and j). Osseous invasion is apparent.
case_images: TOORTHJ-11-417_F1.jpg
case_images: PMC5447904_02_TOORTHJ-11-417_F1.jpg
case_images: F1
case_images: Irregularity in the adjacent bone surfaces was observed (Fig. 1a). Osseous invasion was evident (Figs. 1b-j).
case_images: Images of an extra-articular tenosynovial chondromatosis of the index finger in a 65-year-old female (the same patient in Fig. (1)). Low-magnification views of H&E stained histology sections showing multiple cartilaginous nodules (a and b). H&E stained histology sections of cartilaginous cells with chondroid stroma (c) and cartilaginous nodules lined by synovium (d). Resected specimens of extraosseous (top) and intraosseous (bottom) origin (e). Original magnifications of panels: a and b, x40; c, x100; d, x200.
case_images: TOORTHJ-11-417_F2.jpg
case_images: PMC5447904_02_TOORTHJ-11-417_F2.jpg
case_images: F2
case_images: The features are compatible with synovial chondromatosis (Fig. 2).
case_images: PMC5447904_03
case_images: A 46-year-old female with extra-articular tenosynovial chondromatosis of the middle finger. Plain radiographs of the finger show an osseous nodule in the middle finger (a). The lesion has heterogeneous low- to high-signal intensity on T1-weighted (b), T2-weighted (c), and T2-weighted fat-suppression (d) images. A photograph of the resected specimen (e). Images of H&E histology sections of cartilaginous nodules with ossification and bone marrow-like fat tissue (f). Original magnification of panel f: x10 (top) and x40 (bottom).
case_images: TOORTHJ-11-417_F3.jpg
case_images: PMC5447904_03_TOORTHJ-11-417_F3.jpg
case_images: F3
case_images: Plain radiographs of the hand showed a small osseous node in the middle finger at the radial flexor side (Fig. 3a). Foci of high signal intensity were also observed in the T1- and T2-weighted images, suggesting the presence of fatty tissue (Figs. 3b-d). The features are compatible with synovial chondromatosis (Figs. 3e and f).
case_images: PMC5447904_04
case_images: Images of a 66-year-old male with extra-articular tenosynovial chondromatosis of the right ring finger. Plain radiographs of the hand showed no abnormality (a). An MRI showing multinodular lesions with homogeneous low signal intensity on the T1-weighted images (b and d) and heterogeneous low to high signal intensity on the T2-weighted images (e) on the dorsal side of the proximal phalanx. Fat suppression on the T2-weighted images demonstrates an extension of the lesion (c and f). The top and bottom images of panel d-f are sequential.
case_images: TOORTHJ-11-417_F4.jpg
case_images: PMC5447904_04_TOORTHJ-11-417_F4.jpg
case_images: F4
case_images: No calcification was observed (Fig. 4a). T1-weighted images and heterogeneous low to high signal intensity on the T2-weighted images (Figs. 4b-f). The resection was performed under general anesthesia, with a tourniquet applied at the upper arm, and a mid-dorsal incision was made.