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Para-articular Osteochondroma of the Knee

Published:November 29, 2006DOI:https://doi.org/10.1016/j.arthro.2006.05.030

      Abstract

      We report a case of para-articular chondroma located in the infrapatellar fat pad of the knee of a 42-year-old woman with a history of anterior knee pain and restricted range of motion. On clinical examination, a solid palpable mass in the infrapatellar region was detected. Radiography and computed tomography of the knee revealed the presence of 3 different “popcorn”-like gross calcifications within Hoffa’s fat pad. Magnetic resonance imaging showed areas of signal intensity in Hoffa’s fat pad that were consistent with calcific nodules surrounded by chondral tissue. During arthroscopy, a dense extrasynovial mass was discerned within Hoffa’s fat pad. The mass was entirely removed through an open approach medial to the patellar tendon. Resection specimens consisted of 3 well-circumscribed nodules of 5 × 2.5 × 1.5, 2 × 2 × 1, and 1.5 × 2 × 1 cm, respectively. Grossly, these nodules were surrounded by adipose tissue and presented a thin fibrous membrane. Histologic examination showed that the nodules were composed of cartilaginous tissue surrounded by fibrous connective and adipose tissue with multifocal endochondral ossification. The precise pathogenetic mechanism of these tumors remains unknown, but cartilaginous metaplasia of articular and para-articular connective tissue seems to be the primary cause. Patients with these lesions are currently treated with the use of marginal resection or excision.

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      References

        • Resnick D.
        • Niwayama G.
        Diagnosis of bone and joint disorders. WB Saunders, Philadelphia1988: 3602-4010
        • Marcial-Seoane R.A.
        • Marcial-Seoane M.A.
        • Ramos E.
        • Marcial-Rojas R.A.
        Extraskeletal chondromas.
        Bol Assoc Med P R. 1990; 82: 394-402
        • Fechner R.E.
        • Mills S.E.
        (Series 3, Fascicle 8)Atlas of tumor pathology: Tumors of the bones and joints. Armed Forces Institute of Pathology, Washington, DC1993 (79-128,279-291)
        • Milgram J.W.
        • Dunn E.
        Para-articular chondromas and osteochondromas: A report of three cases.
        Clin Orthop Relat Res. 1980; 148: 147-151
        • Enneking W.F.
        Musculoskeletal tumor surgery. Churchill Livingstone, New York1983: 99
        • Li C.
        • Arger P.H.
        • Dalinka M.K.
        Soft tissue osteochondroma: A report of three cases.
        Skeletal Radiol. 1989; 18: 435-437
        • Reith J.D.
        • Bauer T.W.
        • Joyce M.J.
        Paraarticular osteochondroma of the knee: Report of 2 cases and review of the literature.
        Clin Orthop Relat Res. 1997; 334: 225-232
        • Mosher J.F.
        • Kettelkamp D.B.
        • Campbell C.J.
        Intracapsular or para-articular chondroma: A report of three cases.
        J Bone Joint Surg Am. 1966; 48: 1561-1569
        • Jaffe H.
        Tumors and tumorous conditions of the bones and joints. Lea and Febiger, Philadelphia1958: 558-567
        • Gonzalez-Lois C.
        • Garcia-de-la-Torre P.
        • SantosBriz-Terron A.
        • Vila J.
        • Manrique-Chico J.
        • Martinez-Tello J.
        Intracapsular and para-articular chondroma adjacent to large joints: Report of three cases and review of the literature.
        Skeletal Radiol. 2001; 30: 672-676
        • Milgram J.W.
        • Jasty M.
        Case report 238: Para-articular osteochondroma of the knee.
        Skeletal Radiol. 1983; 10: 121-125
        • Steiner G.C.
        • Meushar N.
        • Norman A.
        • Present D.
        Intracapsular and paraarticular chondromas.
        Clin Orthop Relat Res. 1994; 303: 231-236
        • Rodriguez-Peralto J.L.
        • Lopez-Barea F.
        • Gonzalez-Lopez J.
        Intracapsular chondroma of the knee: An unusual neoplasm.
        Int J Surg Pathol. 1997; 5: 49-54
        • Chung E.B.
        • Enzinger F.M.
        Chondroma of soft parts.
        Cancer. 1978; 41: 1414-1424