There have been few reports on synovial osteochondromatosis in the subacromial bursa. We have experienced a case of synovial osteochondromatosis in the subacromial bursa ( case 1 ), a case of huge calcium deposits in the subacromial bursa assocdated with synovial osteochondromatosis (case 2) and case of fumoral calcinosis around the subacromdal bursa ( case 3 ). Radiological analysis was performed on these casen which showed a synovial ostechondromatosis-like shadow in the subacromial bursa.
Case 1: A 37-year-old female. The X-ray film of her left shoulder showed 4 calcified free bodies in the subacromial bursa. A bursoscope revealed only the free bodies without any synovitis inside the bursa. Pathological examination of the synovial tissue demonstrated that there were no inflammatory signs nor metaplastic osteochondral cells. We diagnosed it as synovial osteochondromatosis ( Milgram phase III).
Case 2 An 8 5-year-old female. The X-ray film showed multiple lobular calcification and several calcified free bodies in the subacromial bursa, the subdeltoid bursa, and the subcoracoid bursa. The mass of lobular calcification was markedly reduced within one year after multiple of corticosteroid into the bursa, although the free bodies remained unchanged. We concluded that this pathological condition was calcifying bursitis and synovial osteochondromatosis.
Case 3: A 53-year-old female. She complained of painles s swelling of the anterior aspect of her right elbow, the posterior aspect of her right shoulder, and the anterior aspect of her left shoulder. She cad undergone haemodialysis from 1980 until recently. The X-ray film showed shadows of multiple lobular calcification around the bilateral subacromial bursa, the subdeltoid bursa and the right elbow joint. Pathological examination of the tumor showed multiple cysts separated by connective tissue septa. There was an area of necrosis at the center of the tumor which was surrounded by a diffuse mass of calciffication. The macrophages of foreign body reaction surrounded the calcified mass, and these multiple foci constituted the tumor. We diagnosed it as tumoral calcinosis.
