Advanced imaging findings and computer‐assisted surgery of suspected synovial chondromatosis in the temporomandibular joint

Abstract

Synovial chondromatosis of the joint occurs mainly in teenagers and young adults. Only 3% of these neoplasms are located in the head and neck region. Synovial chondromatosis of the temporomandibular joint is therefore a very rare disorder. Therefore, developing a working, histological confirmation is required for differential diagnosis. In this case series, the outcome of histological investigation and imaging techniques are compared. Based on clinical symptoms, five cases of suspected synovial chondromatosis of the temporomandibular joint are presented. In each of the subjects, the diagnosis was confirmed by histology. Specific imaging features for each case are described. The tomography images were compared with the histological findings. All patients demonstrated preauricular swelling, dental midline deviation, and limited mouth opening. Computer‐assisted surgery was performed. Histology disclosed synovial chondromatosis of the temporomandibular joint in four cases. The other case was found to be a developmental disorder of the tympanic bone. The diagnosis of synovial chondromatosis of the temporomandibular joint can only be based on histology. Clinical symptoms are too general and the available imaging techniques only show nonspecific tumorous destruction, infiltration, and/or residual calcified bodies, they are only for advanced cases. A rare developmental disorder of the tympanic bone—persistence of foramen of Huschke—has to be differentiated. J. Magn. Reson. Imaging 2008;28:1251–1257. © 2008 Wiley‐Liss, Inc.

Intra- and extracapsular synovial chondromatosis of the temporomandibular joint: Rare case and review of the literature

“…With only 3% of all reported cases, SC is uncommon in the TMJ. 3 , 5 This first discovery of the SC in the TMJ was made by Axhausen 6 in 1933. Since then, only around 200 cases of SC affecting the TMJ were reported in the literature.…”

Foramen tympanicum or foramen of Huschke: anatomical cone beam CT study

“…They may, however, persist in a few rare cases. 2,3 Many factors affect the ossification process of the tympanic bone after birth. The mechanical environment of the mandible such as mastication, deglutition and respiration against the tympanic bone is one factor to consider.…”

“…1,2 The foramen is located at the antero-inferior aspect of the external auditory canal (EAC), posteromedial to the temporomandibular joint (TMJ). 1,3 The foramen of Huschke may predispose individuals to TMJ pathology or it may be associated with salivary discharge into the EAC during mastication.…”

Synovial chondromatosis of the temporomandibular joint: a case description with systematic literature review

“…The main clinical symptoms are preauricular swelling, pain, limitation of jaw movement and crepitus joint sounds. The diagnosis is made by computerized tomography (CT) and magnetic resonance imaging (MRI) 22 . Surgery is the therapeutic choice to remove nodules and loose bodies from the joint space.…”