Diagnosis of Synovial Chondromatosis of Temporomandibular Joint: Case Report and Literature Review

Destruhaut, Florent; Dubuc, Antoine; Bos, Aurélien; Fabié, Laurent; Pomar, Philippe; Combadazou, Jean-Claude; Hennequin, Antonin; Laurencin‐Dalicieux, Sara

doi:10.3390/healthcare9050601

Cited by 3 publications

(6 citation statements)

References 25 publications

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“…SC in the TMJ occurred more often in women, but SC in the large joints occurred more often in men. [11][12][13] This gender-specific prevalence of SC in TMJ was similar to that of TMD. 14,15 This may be related to the effect of estrogen on TMJ, which needs further study.…”

Section: Discussionsupporting

confidence: 61%

Temporomandibular joint synovial chondromatosis: An analysis of 7 cases and literature review

et al. 2022

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Objective: To investigate the diagnosis and treatment procedure of synovial chondromatosis (SC) of the temporomandibular joint (TMJ). Methods: Clinical features, imaging features, surgical methods, and prognosis of 7 patients with SC of the TMJ were analyzed. We also reviewed and analyzed surgery-relevant literature included in the Pubmed database in the past decade using the search terms “synovial chondromatosis” and “temporomandibular joint”, and found 181 cases. Results: There was no specific difference in the symptoms of SC in the TMJ in different Milgram’s stages in our cases and the cases mentioned in the literature. The main symptoms of SC in the TMJ were pain (100%, 7/7; 64.64%, 117/181), limited mouth opening (57.14%, 4/7; 53.59%, 97/181), swelling (14.29%, 1/7; 28.18%, 51/181), crepitus (28.57%, 2/7; 19.34%, 35/181), and clicking (14.29%, 1/7; 9.94%, 18/181) in our cases and cases from literature separately. The imaging features of SC were occupying lesions (including loose bodies or masses) (71.42%, 5/7; 37.57%, 68/181), bone change in condyle or glenoid fossa (1/7, 14.29%; 34.81%, 63/181), effusion (42.86%, 3/7; 20.99%, 38/181), joint space changes (42.86%, 3/7; 11.05%, 20/181) in our cases and cases from literature separately. The surgical procedures seem to depend mainly on the involved structures and the extension of the lesion rather than the Milgram’s stage. Conclusions: The clinical features of SC in the TMJ are nonspecific and easy to be misdiagnosed. MRI is helpful in the diagnosis of SC in the TMJ. The surgical procedures mainly depend on the involved structures and the extension of the lesion.

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Section: Discussionsupporting

confidence: 61%

Temporomandibular joint synovial chondromatosis: An analysis of 7 cases and literature review

et al. 2022

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“…8,9 Women were more likely to experience TMJ SC, whereas men were more likely to experience SC in the larger joints. 10,11 The prevalence of SC in TMJ was gender-specific and comparable to that of TMD. 12,13 It may be connected to the way oestrogen affects TMJ.…”

Section: Discussionmentioning

confidence: 86%

Synovial chondromatosis of the temporomandibular joint

Bukhsh,

Alzaid,

Alshawaf

et al. 2023

Int J Community Med Public Health

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When cartilage-like tissue is present in the synovial membrane of joints, it is known as synovial chondromatosis (SC). The main cause is believed to be the metaplasia of embryonal mesenchymal tissue in the synovial membrane. The metaplastic foci grow within the joint space and can detach from the synovial wall, forming free-floating bodies. While SC is more commonly associated with trauma in the temporomandibular joint (TMJ), the exact relationship between trauma and SC remains unclear. Improved diagnostic techniques, such as CT and MRI, have led to increased recognition of SC in the TMJ. Gender differences in the prevalence of TMJ SC have been observed, with women being more affected. Diagnosis involves imaging techniques like X-rays, CT scans, MRIs, and surgical removal of loose bodies is the preferred treatment. Arthroscopy is recommended for small, isolated loose bodies, while open surgery may be necessary for complete removal. Long-term follow-up is essential to monitor for recurrence. Histopathological findings reveal a mixture of cartilage and bone, with ossification and calcification present.

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“…In general, joint TMD conditions are more common in females, in the age group close to that of CS, which could be a relationship with the predisposition to develop CS [26,27] . When analyzing the signs and symptoms related to SC, it is possible to observe a similarity with those present in TMD, which justifies the need to carry out the differential diagnosis, among them, the following stand out: uni or bilateral preauricular edema; pain aggravated by factors such as chewing or palpation; reduced mouth opening; deviation in mouth opening; muscle fatigue; joint noises and crepitus [3][4][5]16,20] , therefore, in order to perform the differential diagnosis, it is necessary to use image tests.…”

Section: Discussionmentioning

confidence: 99%

“…Surgery involves a preauricular approach followed by synovectomy and resection of the lesion. In some cases, condylectomy may also be necessary [4,5,13,17] .…”

Section: Discussionmentioning

confidence: 99%

“…Its main clinical features involve pre-auricular pain, swelling in the affected region, limited mouth opening, crackles and deviations in mouth opening, clinical signs that are similar to those found in TMD [3][4][5] . Chen et al, (2012), establishes a classification, which uses clinical-radiological parameters to classify SC in the lower region of the TMJ, which has a more updated specification, which uses clinical-radiological parameters to classify SC in this inferior region.…”

Section: Introductionmentioning

confidence: 94%

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2023

World J. Biol. Pharm. Res.

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Introduction: Synovial Chondromatosis (SC) is a metaplastic rheumatologic condition that manifests itself in the Temporomandibular Joints (TMJs). This causes common symptoms related to Temporomandibular Disorders (TMD). Differential diagnosis is obtained through clinical and imaging evaluation.Objective: To clarify, through a systematic review, the manifestations that characterize, differentiate and relate SC in the TMJ from the point of view of clinical and imaging diagnosis. Material and methods:The PubMed database and the keywords were used: Synovial Chondromatosis, Clinical Diagnosis, Imaging Tests, TMD Patient, Healthy Patients, Signs and Symptoms. Inclusion criteria were: five years, English language, title covering the keywords and clinical and original research in humans, literature reviews and case reports. As exclusion criteria: cases that did not deal with SC in the ATM, articles that do not match the objective of the work. The characteristiSC, differences and relationships between TMD and SC were the main variables analyzed.Results: Initially, 335 articles were found, after application of filters, inclusion criteria and evaluation of abstracts, nine were selected. Five relevant publications were added. The signs and symptoms common to the alterations: localized joint pain, edema, limitation of mouth opening and joint noises. Magnetic resonance images, computed tomography and TMJ radiographs were fundamental for the differential diagnosis and indicated the presence of intraarticular fibrocartilaginous bodies in the SC. Conclusion:It is necessary to interpret the imaging tests in order to establish the differential diagnosis between TMD and SC.

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Diagnosis of Synovial Chondromatosis of Temporomandibular Joint: Case Report and Literature Review

Cited by 3 publications

References 25 publications

Temporomandibular joint synovial chondromatosis: An analysis of 7 cases and literature review

Temporomandibular joint synovial chondromatosis: An analysis of 7 cases and literature review

Synovial chondromatosis of the temporomandibular joint

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