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Vol 81, No 3 (2022)
Original article
Submitted: 2021-04-23
Accepted: 2021-05-07
Published online: 2021-05-25
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Primary synovial chondromatosis: an elemental investigation of a rare skeletal pathology

A. W. Beger1, J. A. Millard1, A. Bresnehan1, B. Dudzik1, S. Kunigelis2
DOI: 10.5603/FM.a2021.0054
·
Pubmed: 34060645
·
Folia Morphol 2022;81(3):685-693.
Affiliations
  1. Anatomy Department, DeBusk College of Osteopathic Medicine, Lincoln Memorial University, Harrogate, TN, United States of America
  2. Physiology Department, DeBusk College of Osteopathic Medicine, Lincoln Memorial University, Harrogate, TN, United States of America

open access

Vol 81, No 3 (2022)
ORIGINAL ARTICLES
Submitted: 2021-04-23
Accepted: 2021-05-07
Published online: 2021-05-25

Abstract

Background: Primary synovial chondromatosis (PSC) is a rare idiopathic pathology characterised by the formation of osseocartilaginous nodules within synovial joints, tendons, or bursae. The mineralisation pattern of PSC nodules is poorly understood and has yet to be investigated using elemental analysis. Mapping this pattern could elucidate the progression of the disease.
Materials and methods: Primary synovial chondromatosis nodules discovered during dissection of a formalin fixed donor were analysed. Scanning electron microscopy paired with energy dispersive X-ray spectroscopy (SEM-EDS) was used to quantify calcium and phosphorus levels to distinguish mineralised components from cartilage, indicated by increased carbon and oxygen concentrations.
Results: Nine nodules with average dimensions 1.76 cm × 1.25 cm were identified in the semimembranosus bursa. SEM-EDS demonstrated increased calcium phosphate levels in nodular cores, while outer margins contained primarily carbon and oxygen. Quantification of these elements revealed nodular peripheries to contain 68.0% carbon, 30.2% oxygen, 0.8% calcium, and 1.0% phosphate, while cores were comprised of 38.1% carbon, 42.1% oxygen, 14.1% calcium, and 5.7% phosphate.
Conclusions: Nodules were found to have mineralised cores embedded within a cartilaginous matrix. This pattern suggests disease progression is facilitated by endochondral ossification, opening the potential for new therapeutic techniques.

Abstract

Background: Primary synovial chondromatosis (PSC) is a rare idiopathic pathology characterised by the formation of osseocartilaginous nodules within synovial joints, tendons, or bursae. The mineralisation pattern of PSC nodules is poorly understood and has yet to be investigated using elemental analysis. Mapping this pattern could elucidate the progression of the disease.
Materials and methods: Primary synovial chondromatosis nodules discovered during dissection of a formalin fixed donor were analysed. Scanning electron microscopy paired with energy dispersive X-ray spectroscopy (SEM-EDS) was used to quantify calcium and phosphorus levels to distinguish mineralised components from cartilage, indicated by increased carbon and oxygen concentrations.
Results: Nine nodules with average dimensions 1.76 cm × 1.25 cm were identified in the semimembranosus bursa. SEM-EDS demonstrated increased calcium phosphate levels in nodular cores, while outer margins contained primarily carbon and oxygen. Quantification of these elements revealed nodular peripheries to contain 68.0% carbon, 30.2% oxygen, 0.8% calcium, and 1.0% phosphate, while cores were comprised of 38.1% carbon, 42.1% oxygen, 14.1% calcium, and 5.7% phosphate.
Conclusions: Nodules were found to have mineralised cores embedded within a cartilaginous matrix. This pattern suggests disease progression is facilitated by endochondral ossification, opening the potential for new therapeutic techniques.

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Keywords

scanning electron microscopy, energy dispersive X-ray spectroscopy, nodules, loose bodies, semimembranosus bursa, popliteal cyst

About this article
Title

Primary synovial chondromatosis: an elemental investigation of a rare skeletal pathology

Journal

Folia Morphologica

Issue

Vol 81, No 3 (2022)

Article type

Original article

Pages

685-693

Published online

2021-05-25

Page views

4583

Article views/downloads

1396

DOI

10.5603/FM.a2021.0054

Pubmed

34060645

Bibliographic record

Folia Morphol 2022;81(3):685-693.

Keywords

scanning electron microscopy
energy dispersive X-ray spectroscopy
nodules
loose bodies
semimembranosus bursa
popliteal cyst

Authors

A. W. Beger
J. A. Millard
A. Bresnehan
B. Dudzik
S. Kunigelis

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