Chondrolysis of the Glenohumeral Joint After Arthroscopy

Chondrolysis of joints may occur rapidly after arthroscopy and is characterized by widespread chondrocyte death over a relatively short time. Chondrolysis has been shown to occur in response to intra-articular chemicals (e.g., case reports of methylmethacrylate in the hip and chlorhexidine in the knee). The exact cause in the shoulder is unknown.

Planar radiographs will show uniform loss of the joint space, diffuse subchondral sclerosis and cyst formation on both sides of the joint, and no osteophyte formation. The last of these features helps differentiate this rapid process from osteoarthritis.

In addition to the above, MRI will show extensive loss of articular cartilage on both sides of the joint with focal areas of subchondral signal abnormality corresponding to bone marrow edema and sclerosis.

The main differential considerations are

• Osteoarthritis: Look for osteophytes
• Infectious synovitis: Look for a thick, enhancing capsule; a large joint effusion; and erosions.
• Reactive synovitis: Look for a thick, enhancing capsule; a large joint effusion; and erosions.

References

Sanders TG, Zlatkin MB, Paruchuri NB, Higgins RW. Chondrolysis of the glenohumeral joint after arthroscopy: findings on radiography and low-field-strength MRI. AJR Am J Roentgenol. 2007 Apr;188(4):1094-8.