Primary Synovial Osteochondromatosis of the Elbow in a Young Adult Complicated by Osteoarthritis: A Case Report

Primary synovial osteochondromatosis is a benign and uncommon pathology, resulting from metaplasia of the synovial tissue, of unknown cause, leading to the formation of multiple cartilaginous nodules, some of which secondarily detach to form free articular bodies. Its location in the elbow, complicated by osteoarthritis, is poorly described in the literature. We present the case of a 25-year-old man presenting for chronic right elbow pain with joint locking and swelling without a history of trauma. Physical examination revealed an increase in elbow volume compared to the contralateral elbow, with limitation of active or passive joint range of motion. Radiological examinations, including standard radiography (X-rays), CT, and MRI, revealed multiple rounded, floating, and calcified bodies disseminated in the joint associated with arthritic changes, confirming the diagnosis of primary synovial osteochondromatosis complicated by osteoarthritis. Synovectomy combined with arthroscopic debridement and removal of loose bodies was performed, resulting in significant improvement in pain and joint function. Pathological examination confirmed the diagnosis of primary synovial osteochondromatosis. Elbow involvement is unusual and often diagnosed late due to nonspecific symptoms. Imaging is essential for early diagnosis and to assess synovial extension and cartilaginous complications.