Synovial chondromatosis of the temporomandibular joint: MRI findings with pathological comparison

Abstract

Objectives: The aim of this retrospective study was to characterize MRI findings of synovial chondromatosis in the temporomandibular joint (TMJ) by correlation with their pathological findings. Methods: 22 patients with synovial chondromatosis in unilateral TMJ were referred for plain MRI prior to surgical management and pathological examinations. Parasagittal and coronal proton density-weighted imaging and T 2 weighted imaging were performed for each case. Results: MRI demonstrated multiple chondroid nodules and joint effusion in all patients (100%) and amorphous iso-intensity signal tissues within expanded joint space and capsule in 19 patients (86.4%). On T 2 weighted imaging, signs of low signal nodules within amorphous iso-intensity signal tissues were used to determine the presence of attached cartilaginous nodules in pathology, resulting in 100% sensitivity, 60% specificity and 90.9% accuracy. Signs of low and intermediate signal nodules within joint fluids were used to detect loose cartilaginous nodules and resulted in 80% sensitivity, 42.9% specificity and 68.2% accuracy. Conclusions: MRI of synovial chondromatosis in TMJ was characterized by multiple chondroid nodules, joint effusion and amorphous iso-intensity signal tissues within the expanded space and capsule. The attached cartilaginous nodules in pathology were better recognized than the loose ones on MRI. Plain MRI was useful for clinical diagnosis of the disorder.

Expanding the taxonomy of the diagnostic criteria for temporomandibular disorders

“…Crepitus as per I.3.A (DJD) Imaging: TMJ MRI or CT/CBCT is positive for at least one of the following : 1. MRI: multiple chondroid nodules, joint effusion and amorphous iso‐intensity signal tissues within the joint space and capsule OR2. CT/CBCT: loose calcified bodies in the soft tissues of the TMJ Laboratory testing: 1.…”

Synovial chondromatosis of the temporomandibular joint: CT and MRI findings

“…MRI features [6] mainly include joint effusion, which is best depicted on T2-weighted sequences, loose bodies within the joint space, proliferative synovium, expanded joint capsule, anterior displacement of the mandibular condyle and intracranial involvement. Thanks to its high contrast resolution, extension of the disease into neighbouring structures is best appreciated using this modality.…”

Ear and Temporal Bone: Cartilaginous and Osseous Pathologies

“…As an articular joint the recognition of synovium and the associated entity of chondromatosis although rare should be considered in cartilaginous lesions of this area and not mistaken for a cartilaginous malignancy. Imaging findings are valuable to correlate with both site of the lesion and the characteristics of the process for the differential diagnostic considerations [14]. Knowing the site of biopsy tissue and awareness of a mass associated with the TMJ is critical information.…”