case_images: PMC8046480_01
case_images: Significant restriction in forward flexion and internal rotation at the right shoulder joint on presentation.
case_images: JOCR-11-59-g001.jpg
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case_images: F1
case_images: Physical examination revealed stiffness and crepitus over the right shoulder joint with severe restriction of abduction, forward flexion, and internal rotation (Fig. 1).
case_images: Plain radiograph of the right shoulder joint showing multiple well defined calcific foci with central lucency.
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case_images: F2
case_images: Plain radiographs (Fig. 2) and computed tomography (including three dimensional reconstruction images) (Fig. 3) revealed multiple well-defined calcified foci with central lucency engulfing glenohumeral joint (intra- and extra-articular) anteriorly, posteriorly, superiorly, and inferiorly including biceps tendon consistent with synovial chondromatosis.
case_images: Magnetic resonance imaging showed multiple lobulated, osseocartilagenous loose bodies with moderate synovial effusion.
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case_images: F4
case_images: Magnetic resonance imaging done suggested moderate synovial effusion with synovial thickening and early degenerative changes with loose bodies which were consistent with the findings on computed tomography (Fig. 4).
case_images: Arthroscopic view (left) showing osteochondral loose bodies between glenoid and humeral head and post-excision empty axillary region of glenohumeral joint (right).
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case_images: F5
case_images: Active, intrasynovial proliferation was noted with intra-articular and extra-articular loose bodies (Fig. 5). With motorized shaver, partial synovectomy was performed using anterosuperior and anteroinferior portals and by inter-changing the portals frequently, the osteochondral loose bodies were removed with larger arthroscopic grasper (Fig. 5).
case_images: Excised loose bodies measuring 0.3-3.5 cm in size.
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case_images: F6
case_images: Approximately 20 fragments, ranging in size from 0.3 to 3.5 cm, were removed (Fig. 6) over a duration of 1 h.
case_images: Clusters of chondrocytes showing binucleation on histopathology.
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case_images: F7
case_images: The histopathological examination of the loose bodies and synovial tissue confirmed the presence of cartilaginous synovial metaplasia consistent with synovial chondromatosis (Fig. 7).
case_images: Comparison of plain radiograph of the right shoulder joint pre- and post-operatively - loose bodies around the glenohumeral joint were extracted.
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case_images: F8
case_images: Post-operative plain radiograph was done (Fig. 8).
case_images: Full range of movement at 4 weeks post-operatively.
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case_images: F9
case_images: By 4 weeks post-operatively, the patient could return to work (Fig. 9).