Short communicationBilateral synovial chondromatosis of the temporomandibular joint☆
Introduction
Synovial chondromatosis (SC) is a rare monoarticular arthropathy of unknown aetiology characterized by the development of cartilaginous bodies in the synovial membrane and joint space. Pathologically, this condition is considered to be a metaplastic disease of the synovial connective tissue (Lieger et al., 2007). It is more common in larger joints such as the knee, elbow, wrist, shoulder and hip, whereas involvement of the temporomandibular joint (TMJ) is unusual (Von Lindern et al., 2002, Ardekian et al., 2005, Lieger et al., 2007). The first description of SC of the TMJ was made by Georg Axhausen in 1933. Subsequently about 80 cases have been added to the scientific literature. In the Journal of Cranio-Maxillofacial Surgery, two series (Norman et al., 1988, Carls et al., 1995a) and several isolated cases (Cho-Lee et al., 2008, Guijarro-Martínez et al., 2008) have been reported during the last two decades. The advantages of arthroscopy for diagnosis and a reduction of operative trauma have been documented (Carls et al., 1995a, Carls et al., 1995b, Fernández et al., 2006). Involvement of both TMJs with SC is extremely rare in the scientific literature, only two cases have been reported prior to this one.
The purpose of this article is to present a case of bilateral SC of the TMJ and to discuss current diagnostic approaches, treatment options and relevant follow-up data.
Section snippets
Case report
A 38-year-old woman was referred to our Department of Oral and Maxillofacial Surgery with a 12-month history of unilateral preauricular swelling, progressive local pain and intermittent headaches. Her medical history was non-significant.
Clinical examination revealed a tender elastic mass in the left preauricular region. Clicking of the left TMJ and slight deviation of the mandible to the right were evident with mouth opening, which was painful but unrestricted (40 mm).
Initial imaging studies
Discussion
SC is rare in the TMJ. “Synovial chondrometaplasia”, “osteochondromatosis” or “synovial chondrosis” are often used synonymously. Bilateral involvement is exceptional to our knowledge, only two cases besides this one have been reported (Keogh et al., 2002, Peng et al., 2009).
Although some authors identify cytogenetic features suggesting clonal proliferation (Szendrói and Deodhar, 2000) and others even regard SC as a chondrogenic neoplasm (Von Lindern et al., 2002, Adachi et al., 2008), the
Conclusion
SC is an uncommon condition in the TMJ. It should be included in the differential diagnosis of preauricular pain, swelling and crepitus. Bilateral involvement is extremely rare. MRI is a valuable tool for both diagnosis and postoperative follow-up, which must be long-term. Complete removal of the involved tissue usually gives an excellent prognosis. As awareness of this uncommon clinical condition continues to increase and new imaging tools become available, early diagnosis and proper surgical
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2023, Oral Surgery, Oral Medicine, Oral Pathology and Oral RadiologyCitation Excerpt :It is rarely present in TMJ; however, when it affects such joints, in most cases, the patient is an adult between 21 and 66 years old and female in the proportion 2:1. It can occur in 1 or both joints, being more common in 1 TMJ.9,23 The case reports presented here corroborate the literature because all cases were unilateral and in women >45 years of age (48, 55, and 57), showing the prevalence of this disease in middle-aged women.
Clinical and Imaging Findings of Temporomandibular Joint Synovial Chondromatosis: An Analysis of 10 Cases and Literature Review
2016, Journal of Oral and Maxillofacial SurgeryCitation Excerpt :No patients had recurrence during this period. The clinical characteristics of 109 cases with SC of the TMJ collected from 40 reports are presented in Table 2.3-42 A summary of the general results of all cases with SC of the TMJ (including those from our hospital from 2011 through 2015) is shown in Table 3.
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2016, Revista Espanola de Cirugia Oral y Maxilofacial
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