Clinical and Imaging Findings of Temporomandibular Joint Synovial Chondromatosis: An Analysis of 10 Cases and Literature Review

Liu, Xingguang; Huang, Zhongyang; Zhu, Wangyong; Liang, Peisheng; Tao, Qian

doi:10.1016/j.joms.2016.04.029

Cited by 34 publications

(19 citation statements)

References 45 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…More than 200 cases of TMJSC had been presented in literatures . The existence of LBs in TMJ causes joint pain, limited mouth opening and degenerative changes for disc, condyle and glenoid fossa even skull base, which impedes normal function of TMJ.…”

Section: Introductionmentioning

confidence: 99%

Role of synovium‐derived fibrous cartilage in temporomandibular joint synovial chondromatosis

Feng

Cao

et al. 2018

J Oral Pathology Medicine

View full text Add to dashboard Cite

Background: Synovial chondromatosis (SC) of temporomandibular joint (TMJ) occupies 3% SC cases. In other joints like hip and knee which were composed hyaline cartilage (HC), loose bodies (LBs) were reported to be a HC feature. However, condyle surface and disc in TMJ are fibrous cartilage (FC). Therefore, we proposed a different pathogenesis of TMJSC.Methods: LBs and synovium were collected from seven TMJSC patients, and histological and immunohistological examinations were performed.Results: Three ways of HC formation were discovered: regular-shaped cartilaginous nodules (CNs) in sublining layer (SL) of vascularized synovium, regional chondrification of SL, and finger-like tissue with a tail attaching to synovium. Detached LBs could fuse and were only positively stained by aggrecan. Without synovium attachment to LBs, fused LBs remained a hyaline extracellular matrix (ECM). However, after synovium attachment, transformation from HC to FC occurred. Two types of FC were observed. First type FC was featured by vertical-distributed type I collagen fibers imbedding few chondrocytes, suggesting mature phase with superior mechanical features. Second type FC was featured by medium-density chondrocytes with type I collagen and aggrecan-positive ECM, suggesting primary phase. The transformation process started in appearance of 2nd type FC deriving from synovium covering LB, and gradually replaced HC from periphery to center. Conclusions: Three ways of HC formation were closely related. Different with SC in other joints, hyaline ECM in LBs of TMJSC could be replaced by FC deriving from synovium, during which 2nd type FC first replaced HC and then transformed to 1st type FC. K E Y W O R D S angiogenesis, fibrous cartilage, hyaline cartilage, loose bodies, synovial chondromatosis 1 | INTRODUCTION Synovial chondromatosis (SC) is an uncommon, benign and proliferative disorder of subsynovial cartilaginous metaplasia. 1 It is characterized by formation of hyaline cartilaginous nodules (CNs) in sublining layer (SL) of synovium, subsequently separation from synovium and formation of loose bodies (LBs) in joint compartment. 2 Though large joints such as knee, elbow, and hip are usually affected by SC, 3 SC in temporomandibular joint (TMJ) only occupies 3% cases. 4 More than 200 cases of TMJSC had been presented in literatures. 5 The existence of LBs in TMJ causes joint pain, limited mouth opening and degenerative changes for disc, condyle and glenoid fossa 6 even skull base, 7 which impedes normal function of TMJ.

show abstract

Section: Introductionmentioning

confidence: 99%

Role of synovium‐derived fibrous cartilage in temporomandibular joint synovial chondromatosis

Feng

Cao

et al. 2018

J Oral Pathology Medicine

View full text Add to dashboard Cite

show abstract

“…The symptoms include pre-auricular pain and swelling, limitations of mouth opening and condylar movement, joint sound and pain, 3 myalgia of the masticatory muscles, and malocclusion, 4 5 which are quite similar to those of temporomandibular disorder (TMD), making the clinical differential diagnosis difficult. 6 Therefore, the diagnosis is made based mostly on images, including plain radiography, cone-beam computed tomography (CBCT), and magnetic resonance (MR) imaging, 2 7 supplemented by an assessment of the clinical symptoms. The radiographic image findings are numerous calcified loose bodies surrounding the mandibular condyle, 2 3 5 6 7 8 9 10 degenerative changes of the condyle, 3 8 sclerosis of the glenoid fossa and condyle, 7 and rarely, extension into the middle cranial fossa due to excessive bone resorption at the glenoid fossa.…”

mentioning

confidence: 99%

“… 6 Therefore, the diagnosis is made based mostly on images, including plain radiography, cone-beam computed tomography (CBCT), and magnetic resonance (MR) imaging, 2 7 supplemented by an assessment of the clinical symptoms. The radiographic image findings are numerous calcified loose bodies surrounding the mandibular condyle, 2 3 5 6 7 8 9 10 degenerative changes of the condyle, 3 8 sclerosis of the glenoid fossa and condyle, 7 and rarely, extension into the middle cranial fossa due to excessive bone resorption at the glenoid fossa. 7 8 In MR images, loose bodies with a low and heterogeneous signal within high-signal articular space effusion and expansion in T2-weighted images are characteristic findings.…”

mentioning

confidence: 99%

“… 7 8 In MR images, loose bodies with a low and heterogeneous signal within high-signal articular space effusion and expansion in T2-weighted images are characteristic findings. 2 3 7 8 11 …”

mentioning

confidence: 99%

“…The loose bodies and metaplastic synovial membrane tissue are usually removed by surgical excision. 2 7 Arthroscopy can be used for visualization and minimally invasive interventions. 5 9 The recurrence rate is very low, 2 according to Liu et al, 7 who reported only 3 instances of recurrence out of 119 total cases.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Temporomandibular joint synovial chondromatosis accompanying temporal bone proliferation: A case report

et al. 2018

View full text Add to dashboard Cite

Synovial chondromatosis is a rare metaplastic disease affecting the joints, including the temporomandibular joint (TMJ). Since its symptoms are similar to those of temporomandibular disorders, a careful differential diagnosis is essential. A 50-year-old male patient was referred with the chief complaint of pain and radiopaque masses around the left TMJ on panoramic radiography. Clinically, pre-auricular swelling and resting pain was found, without limitation of mouth opening. On cone-beam computed tomographic images, multiple calcified nodules adjacent to the TMJ and bone proliferation with sclerosis at the articular fossa and eminence were found. T2-weighted magnetic resonance images showed multiple signal-void nodules with high signal effusion in the superior joint space and thickened cortical bone at the articular fossa and eminence. The calcified nodules were removed by surgical excision, but the hypertrophic articular fossa and eminence remained. A histopathological examination confirmed the diagnosis. The patient was followed up few months later without recurrence.

show abstract

Bibliography and Further Reading

2021

Atlas of Cone Beam Computed Tomography

View full text Add to dashboard Cite

Clinical and Imaging Findings of Temporomandibular Joint Synovial Chondromatosis: An Analysis of 10 Cases and Literature Review

Cited by 34 publications

References 45 publications

Role of synovium‐derived fibrous cartilage in temporomandibular joint synovial chondromatosis

Role of synovium‐derived fibrous cartilage in temporomandibular joint synovial chondromatosis

Temporomandibular joint synovial chondromatosis accompanying temporal bone proliferation: A case report

Bibliography and Further Reading

Contact Info

Product

Resources

About