Synovial osteochondromatosis (SOC) is a mono-articular arthropathy rarely seen in diarthrodial joints. It occurs 3 times more in males than females and most often in those aged 30 to 50 years. It is a benign metaplastic proliferative disorder of the synovium characterised by the formation of multiple cartilagenous nodules in the synovium. With recent advances in arthroscopic techniques, the indications for arthroscopic treatment have been extended. We report a rare neglected case covering a 12-year period of a locally giant SOC of the elbow in a 30-year-old man. He was presenting a history of loss of range of motion and intermittent locking of the right elbow. Clinical examination revealed a significant increase in size of the right elbow compared to the contra-lateral. Magnetic Resonance images (MRI) showed many calcified bodies spread throughout the elbow joint on coronal and axial slices. Arthroscopy was applied to the right elbow with the patient in the lateral position under general anaesthesia. Approximately 43 free fragments were removed. Postoperatively, the elbow was supported in a sling for ten days and then was mobilized progressively. The clinical and radiological evaluation at 3 and 6 months postoperatively showed reduction in the volume of the elbow, improvement of extension to 10° and flexion to 130°. The advantages of this method include low morbidity, early rehabilitation and higher patient satisfaction. However, patients must be informed that recurrence could occur and should be followed up accordingly.
