Scientific Articles   |    
Hips with Synovial Chondromatosis May Display the Features of Femoroacetabular Impingement
Mansour Abolghasemian, MD1; Kaveh Gharanizadeh, MD1; Paul Kuzyk, MD, FRCSC2; Zahra Masdari, MD1; Mohammad Fakharian, MD3; Oleg Safir, MD, FRCSC2
1 Department of Orthopaedics, Shafa Hospital, Iran University of Medical Sciences, Jaleh Street, Baharestan Square, 1157637131 Tehran, Iran. E-mail addresses for M. Abolghasemian: m-abolghasemian@tums.ac.ir; mn.abolghasemi@yahoo.com
2 Division of Orthopaedics, University of Toronto, 600 University Avenue, Suite 476(A), Toronto, ON M5G 1X5, Canada.
3 Mostafa Hospital, Shahed University, Italy Street, 1416643491 Tehran, Iran
View Disclosures and Other Information
  • Disclosure statement for author(s): PDF

Investigation performed at Shafa Hospital, Iran University of Medical Sciences, Tehran, Iran, and Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada

Disclosure: None of the authors received payments or services, either directly or indirectly (i.e., via his or her institution), from a third party in support of any aspect of this work. None of the authors, or their institution(s), have had any financial relationship, in the thirty-six months prior to submission of this work, with any entity in the biomedical arena that could be perceived to influence or have the potential to influence what is written in this work. Also, no author has had any other relationships, or has engaged in any other activities, that could be perceived to influence or have the potential to influence what is written in this work. The complete Disclosures of Potential Conflicts of Interest submitted by authors are always provided with the online version of the article.

Copyright © 2014 by The Journal of Bone and Joint Surgery, Inc.
J Bone Joint Surg Am, 2014 Jan 15;96(2):e11 1-6. doi: 10.2106/JBJS.L.01550
5 Recommendations (Recommend) | 3 Comments | Saved by 3 Users Save Case



Both synovial chondromatosis and femoroacetabular impingement present with hip pain and may lead to hip osteoarthritis. We present a small case series and describe the clinical presentation, investigation, and treatment of patients with synovial chondromatosis who also had cam-type femoroacetabular impingement involving the same hip.


Five patients (four men and one woman with a mean age of thirty-four years [range, thirty to thirty-seven years]) with unilateral synovial chondromatosis of the hip presented with clinical and radiographic features of ipsilateral cam-type femoroacetabular impingement. The diagnosis of associated synovial chondromatosis was made on the basis of preoperative imaging in four of the cases. All patients were treated with surgical hip dislocation, excision of the synovial chondromatosis loose bodies, and reshaping of the femoral head-neck junction.


These hips exhibited radiographic features that are not typically seen with idiopathic cam-type femoroacetabular impingement, including femoral head hypertrophy, lateralization of the femoral head, and haziness in the acetabular fossa. None of the hips showed signs of advanced osteoarthritis intraoperatively. The alpha angle improved from a mean of 72.4° preoperatively to 42.6° postoperatively. At a mean of twenty-two months of follow-up, the patients had a mean Harris hip score of 80.6, substantially improved from the preoperative value of 39.


Hips with synovial chondromatosis may present with clinical and radiographic features resembling those of cam-type femoroacetabular impingement. As simultaneous treatment of both conditions is best accomplished with surgical hip dislocation rather than other, less-extensive surgical approaches, we recommend preoperative consideration of synovial chondromatosis in patients presenting with unilateral cam-type femoroacetabular impingement.

Level of Evidence: 

Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

Peer Review 

This article was reviewed by the Editor-in-Chief and one Deputy Editor, and it underwent blinded review by two or more outside experts. The Deputy Editor reviewed each revision of the article, and it underwent a final review by the Editor-in-Chief prior to publication. Final corrections and clarifications occurred during one or more exchanges between the author(s) and copyeditors.

Figures in this Article
    Sign In to Your Personal ProfileSign In To Access Full Content
    Not a Subscriber?
    Get online access for 30 days for $35
    New to JBJS?
    Sign up for a full subscription to both the print and online editions
    Register for a FREE limited account to get full access to all CME activities, to comment on public articles, or to sign up for alerts.
    Register for a FREE limited account to get full access to all CME activities
    Have a subscription to the print edition?
    Current subscribers to The Journal of Bone & Joint Surgery in either the print or quarterly DVD formats receive free online access to JBJS.org.
    Forgot your password?
    Enter your username and email address. We'll send you a reminder to the email address on record.

    Forgot your username or need assistance? Please contact customer service at subs@jbjs.org. If your access is provided
    by your institution, please contact you librarian or administrator for username and password information. Institutional
    administrators, to reset your institution's master username or password, please contact subs@jbjs.org


    Accreditation Statement
    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
    CME Activities Associated with This Article
    Submit a Comment
    Please read the other comments before you post yours. Contributors must reveal any conflict of interest.
    Comments are moderated and will appear on the site at the discretion of JBJS editorial staff.

    * = Required Field
    (if multiple authors, separate names by comma)
    Example: John Doe

    Related Content
    The Journal of Bone & Joint Surgery
    JBJS Case Connector
    Topic Collections
    Related Audio and Videos
    PubMed Articles
    [Hip arthroscopy]. Lijec Vjesn 2013 Sep-Nov;135(9-10):246-56.
    Clinical Trials
    Readers of This Also Read...
    JBJS Jobs
    California - UCLA/OH Department of Orthopaedic Surgery
    Pennsylvania - Penn State Milton S. Hershey Medical Center