Synovial chondromatosis of the temporomandibular joint—clinical, surgical, and imaging findings of a Milgram stage III case series

Synovial chondromatosis of the temporomandibular joint (TMJ) is a rare disease characterized by cartilaginous metaplasia of the mesenchymal remnants of the synovial membrane with formation of loose cartilaginous nodules. It is prevalent in middle-aged women and the main clinical characteristics are...

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Published inOral surgery, oral medicine, oral pathology and oral radiology Vol. 135; no. 5; pp. e94 - e101
Main Authors Machado, Gustavo Grothe, Zambon, Camila Eduarda, de Lima, José Manuel da Silva, Paiva, Gustavo Luiz Alkmin, Martins, Victor Adriano de Oliveira, Peres, Maria Paula Siqueira de Melo
Format Journal Article
LanguageEnglish
Published United States Elsevier Inc 01.05.2023
Subjects
Chondromatosis, Synovial - diagnostic imaging
Chondromatosis, Synovial - pathology
Chondromatosis, Synovial - surgery
Female
Humans
Magnetic Resonance Imaging
Middle Aged
Synovial Membrane
Temporomandibular Joint - pathology
Temporomandibular Joint Disorders - diagnostic imaging
Temporomandibular Joint Disorders - pathology
Temporomandibular Joint Disorders - surgery
Tomography, X-Ray Computed
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Summary:Synovial chondromatosis of the temporomandibular joint (TMJ) is a rare disease characterized by cartilaginous metaplasia of the mesenchymal remnants of the synovial membrane with formation of loose cartilaginous nodules. It is prevalent in middle-aged women and the main clinical characteristics are swelling, pain, and limited jaw movements. Diagnosis is difficult, especially in the early stages, because the signs and symptoms are like other TMJ diseases such as internal derangements and tumors. Imaging exams are fundamental in differential diagnosis for detection of synovitis and free cartilaginous bodies. Magnetic resonance imaging with a gadolinium contrast would be of particular interest for this purpose. Treatment involves the removal of the cartilaginous nodules and synovectomy. It can be performed by arthroscopy or arthrotomy depending on the size of the lesion, the number of corpuscles, and the need for auxiliary surgical procedures. Final diagnosis is anatomopathologic. Postoperative follow-up is necessary due to the risk of recurrence.
ISSN:2212-4403
2212-4411
DOI:10.1016/j.oooo.2022.09.005