Differential diagnosis of calcium pyrophosphate dihydrate deposition of the temporomandibular joint

Aoyama, Shigeru; Kino, Koji; Amagasa, Teruo; Kayano, Teruo; Ichinose, Shunsuke; Kimijima, Yutaka

doi:10.1054/bjom.2000.0313

Cited by 53 publications

(38 citation statements)

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“…The joints most commonly affected are the knee, shoulder, hip, elbow, and metacarpophalangeal joints, while axial skeleton involvement (both cranial and spinal) is less common, but reported in the literature. [1][2][3]5,[9][10][11][12][13][14] The origin is unknown but in general, destruction of the joint is required for crystal deposition. 2 Damage with increasing age predisposes to deposition due to changes in joint physiology (phosphate turnover, changes in synovial fluid components).…”

Section: Discussionmentioning

confidence: 99%

“…13 CPDD involvement of the skull specifically has also been reported usually causing severe bony destruction. 1,9,10,12,14 Involvement of the TMJ has been described in the literature in the form of case reports 10,14,15 but was not described in any of the cases originally described by McCarty. 7,12 Disease involving the TMJ typically presents with pain, swelling, and hearing loss.…”

Section: Discussionmentioning

confidence: 99%

“…7,12 Disease involving the TMJ typically presents with pain, swelling, and hearing loss. 9,14,15 In some reports, tumoral calcinosis has been documented but this is generally in the form of hydroxyapatite crystals. 1,2,15 Management of tophaceous pseudogout is surgical.…”

Section: Discussionmentioning

confidence: 99%

“…While some cases have been managed conservatively, symptomatic relief in most published reports occurred only after resection of the lesion. 14,15 Conclusion CPDD can be a rare cause of common symptoms and a high threshold of suspicion is necessary to arrive at the correct etiology. As CPDD often presents in many chronic medical illnesses, neurosurgeons may be the first to diagnose these medical problems by accurately diagnosing a skull base mass as CPDD.…”

Section: Discussionmentioning

confidence: 99%

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Calcium Pyrophosphate Deposition Disease of the Temporomandibular Joint

et al. 2011

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).Calcium pyrophosphate dihydrate deposition disease (CPDD) is a rare crystal arthropathy characterized by the deposition of calcium pyrophosphate crystals in joint spaces, episodes of synovitis, and radiological features of chondrocalcinosis. 1,2 While the disease is most prevalent in the shoulders, pelvis, knees, and joints of the hands, the axial skeleton can be affected, but rarely involves the skull base. 2-4 When involved, CPDD can cause symptoms mimicking more common neurological and neurosurgical pathologies. 2,5 We present a patient who was recently treated at our institution whose pathology demonstrated CPDD. Case ReportThe patient is a 51-year-old right-handed Caucasian woman with a 12-month history of left ear pain that originated from the temporomandibular joint (TMJ), with some associated swelling, pain with chewing, and mild hearing loss. Her physical examination revealed mild hearing loss on the left side. Computed tomography (CT) and magnetic resonance imaging of the temporal fossa revealed a large mass emanating from the temporal bone at the TMJ (►Fig. 1A, 1B), extending into the greater wing of the sphenoid, and involving the mastoid bone and air cells posteriorly. There was erosion of the petrous carotid canal. A CT-guided biopsy was performed which diagnosed the mass as tophaceous pseudogout (tumoral CPDD). Keywords

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Calcium Pyrophosphate Deposition Disease of the Temporomandibular Joint

et al. 2011

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“…Aunque los cristales son débilmente birrefringentes bajo luz polarizada, otros cristales, como los de oxalato cálcico, de esteroides sintéticos y del ácido etilendiaminotetraacético (EDTA) también son birrefringentes. El diagnóstico diferencial debe basarse en el análisis cuantitativo de los cristales o en la observación de la estructura del cristal 8 . Para detectar histológicamente los cristales, el espé-cimen debe ser examinado sin descalcificación, porque en secciones descalcificadas los cristales se pierden y los hallazgos atípicos de condrocitos metaplásicos pueden conducir a un error histológico en el diagnóstico, simulando condrosarcomas, sinovitis villonodular pigmentada o condromatosis sinovial.…”

Section: Discussionunclassified