Combined treatment in a rare case: Bilateral intra-articular and unilateral extra-articular synovial chondromatosis of the knees

BackgroundSynovial chondromatosis (SC) is a rare proliferative disorder characterized by the metaplastic formation of cartilaginous and osteochondral nodules in the synovial membrane of joints, tendon sheaths, or bursae. It most commonly affects the knee, followed in frequency by the elbow, ankle, hip, and shoulder. Although SC usually presents as a monoarticular condition, bilateral, extra-articular, or multifocal involvement is uncommon.Case presentationWe report a 78-year-old patient with a history of cerebrovascular event and coronary artery disease who presented with bilateral intra-articular synovial chondromatosis extending extra-articularly to the right popliteal fossa and quadriceps tendon.InterventionsAfter completing 21 sessions of preoperative rehabilitation, the patient underwent right knee surgery consisting of debridement, synovectomy, and cystectomy.OutcomesPain intensity was assessed using the Visual Analog Scale (VAS), and joint range of motion was recorded.ConclusionAlthough bilateral involvement is rare, SC should be considered in the differential diagnosis of patients presenting with bilateral knee pain and stiffness. We suggest that preoperative rehabilitation may contribute positively to the overall treatment process, and in cases where surgery is declined, rehabilitation alone may lead to improvements in pain and joint mobility.