Synovial Chondromatosis of the Temporomandibular Joint: A Case Report and Literature Review

Abstract

Synovial chondromatosis (SC) is a pathologic condition in which mesenchymal tissue rests in a given synovial membrane undergo a metaplastic process, ultimately producing and secreting cartilaginous bodies into the joint space. It is more commonly discussed in the orthopedic literature, since the axial skeleton is the most frequently affected. Although rare, it does occur within the temporomandibular joint (TMJ), with approximately 100 cases previously being described. Within the TMJ, its presentation can be variable, though most cases will show it to be unilateral with fixed and/or loose cartilaginous bodies confined to the superior joint space. Clinically, patients may present with symptoms similar to that of an internal derangement disorder, including pain, clicking, tenderness, functional limitations, and swelling. A thorough history and physical examination, along with proper radiographic examination, are paramount in properly diagnosing SC. Treatment options consist of arthroscopy, arthrotomy with synovectomy, excision of cartilaginous bodies, and possible discectomy. In the current paper, the authors describe the presentation, diagnosis, and surgical management of a SC case involving the right TMJ in a 31-year-old Caucasian female.

Articular synovial chondromatosis of the finger

“…A review of publications, however, shows that 10 of 17 cases (59%) involving the finger joint were in women [1][2][3][4][5][6][7][8][9][10]. More interestingly, all 9 cases that involved the interphalangeal joint were in women.…”

“…As loose bodies in a finger joint are well-contained within the expanded capsule both dorsally and volarly, locking as a result of entrapped loose bodies between the joint surfaces is rarely recognized [7]. Radiographs show multiple radiopaque densities around the involved joint, depending on the degree of calcification or ossification.…”

“…Various treatments for articular synovial chondroma of the finger joint have been reported, including removal of loose bodies only [8], with partial(subtotal) synovectomy [6], and with complete (total) synovectomy [7]. A review of past reports has shown that the local recurrence rate of articular synovial chondromatosis of the finger joint was 24% (4/17 cases), and was almost twice as high as gross recurrence rate of synovial chondromatosis (12%-15%) [1,2].…”

“…Extra-articular tenosynovial chondromatosis often occurs in the digits, but articular synovial chondromatosis in the digital joints is extremely rare. To our knowledge from past reports listed in PubMed, there have been only 17 cases of articular synovial chondromatosis of the digital joint [1,2,[4][5][6][7][8][9][10]. We present another case of articular synovial chondromatosis of the metacarpophalangeal (MP) joint with a review of 17 other reports.…”

Synovial Chondromatosis of the Temporomandibular Joint – Clinical, CT, MRI, Surgical and Histological Findings: Case Report

“…The subsynovial nodules of hyaline cartilage detached from the synovium to lie down within the spread joint space, and because cartilage is nourished by synovial fluid, the chondral bodies may grow and gradually increase in size in the joint space. Although the number of chondral bodies varies widely, they are most commonly numerous [12]. In the subsequent monitoring for 13 months, were observed absence of pain and crepitus, unforced achieved maximum mouth aperture of 58 mm, and joint noise disappeared completely after surgery.…”