Tophaceous pseudogout of the temporomandibular joint: Report of a case

Abstract

An 85-year-old man was found to have a calcified mass protruding from the joint space of the right temporomandibular joint (TMJ). Microscopically, the removed mass consisted of chondromyxoid tissue with atypical chondrocytes, resembling a cartilaginous tumor. However, the chondromyxoid tissue contained abundant deposits of rod-shaped to rhomboid crystals which proved to be calcium pyrophosphate dihydrate (CPPD) crystals. The review of the literature revealed that tophaceous pseudogout was the most common variant of CPPD deposition disease involving the TMJ.

Calcium pyrophosphate dihydrate arthropathy with condylar destruction of the temporomandibular joint

“…Involvement of the TMJ is rare, and the first report of calcium pyrophosphate dihydrate arthropathy of the TMJ was made by Pritzker et al (1). Only 20 cases of this condition affecting the TMJ have been reported (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16). In the literature, this disease develops more frequently in women (16 cases, 80%), particularly those aged 50-60 years (average age, 57.4 years).…”

“…Other associated conditions or diseases include osteoarthritis, hypothyroidism, amyloidosis, trauma, and surgical intervention. In the literature, coexistent systemic diseases considered to be closely associated with CPPD of the TMJ, including diabetes mellitus, CPPD in the wrist and knee, generalized arthritis, polymyalgia rheumatica, hypothyroidism, hypertension and hiatal hernia, have been described in 8 patients out of 20 reported cases (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16). CPPD deposition disease of the TMJ usually involves the condyle and fibrocartilage (11 out of 20 cases) (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16).…”

Arthroskopische Lysis und Lavage des Kiefergelenks zur Therapie von Diskusverlagerungen

“…[6][7][8][9][10][11][12][13]. 1) wurde eine Arthroskopie des Kiefergelenks in nasaler Intubationsnarkose durchgeführt.…”

“…Beispiele sind, ähnlich den Erkrankungen anderer Körpergelenke, Arthritiden unterschiedlicher Genese oder pathologische Befunde im Bereich des Discus articularis sowie posttraumatische und neoplastische Alterationen [8]. Beispiele sind, ähnlich den Erkrankungen anderer Körpergelenke, Arthritiden unterschiedlicher Genese oder pathologische Befunde im Bereich des Discus articularis sowie posttraumatische und neoplastische Alterationen [8].…”

Calcium pyrophosphate dihydrate crystal deposition disease of the temporomandibular joint

“…Therefore it is surprising that the temporomandibular joint (TMJ), a joint in which fibrocartilage predominates, is rarely affected by CPPD crystal deposition disease. CPPD arthropathy of the TMJ has only been described in 23 cases in the literature (Pritzker et al , 1976; de Vos et al , 1981; Good and Upton, 1982; Zemplenyi and Calcaterra, 1985; Gross et al , 1987; Hutton et al , 1987; Kamatani et al , 1987; Mogi et al , 1987; Lambert et al , 1990; Magno et al , 1992; Chuong and Piper, 1995; Dijkgraaf et al , 1995; Ishida et al , 1995; Pynn et al , 1995; Kurihara et al , 1997; Onodera et al , 1997; Vargas et al , 1997; Aoyama et al , 2000; Osano et al , 2003).…”