A case of osteoarthritis and synovial osteochondromatosis of both shoulders with acromegaly

Abstract

Clinical reports of osteoarthritis and synovial osteochondromatosis of the shoulder in with acromegaly are very rare, and only three cases could be found in the literature. We report a case with that disorder.
The patient was a retired 70-year-old male. From 20 years previously, he had suffered from pain and limited motion in both shoulders. Plain radiography, CT, and MRI showed severe osteoarthritis and a large number of loose bodies in both shoulders, and a giant loose body in the right shoulder. He was diagnosed with osteoarthritis of the shoulder with synovial osteochondromatosis. Furthermore he had characteristic features of acromegaly. He was diagnosed with acromegaly based upon elevated serum levels of growth hormone (GH) and a pituitary tumor on brain MRI. We performed removal of the loose bodies and shoulder hemiarthroplasty on the right shoulder.
His motion pain almost disappered and limited motion moderately improved after surgery.
Our case had the following clinical characteristics of osteoarthritis and synovial osteochondromatosis with acromegaly as reported in literature; there was bilateral symmetric involvement and the osteochondromatosis was more extensive in number and size. GH may play a role as a trigger in the development of synovial chondromatosis in osteoarthritic joints and generate giant loose bodies.