Case

A 30-year-old woman was referred for consideration of arthroscopy. She had a long-standing history of rheumatoid arthritis managed with chronic oral pred-nisone suppressions. She has experienced right hip symptoms for 3 years, but the hip has become increasingly painful over the past 6 months. An in-traarticular injection of corticosteroid failed to provide protracted relief.

Radiographs revealed modes underlying osteope-nia, consistent with her disease, but the joint space has been well maintained (Figure 2.20A). With the chronicity and magnitude of her symptoms and failure of response to conservative treatment including an intraarticular injection, she was thought to be an appropriate candidate for arthroscopy.

At arthroscopy, the articular surfaces were remarkably well maintained, but a proliferative villous synovial process emanated from the capsular lining (Figure 2.20B). This process was debrided with a full-radius synovial resector approaching the synovium from all three portals. Postoperatively, the patient experienced marked improvement of her symptoms.

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