グラム染色が診断に有効であった顎関節偽痛風の1例
Pseudogout is acute arthritis caused by calcium pyrophosphate dehydrate (CPPD). We report a case of pseudogout in the temporomandibular joint (TMJ) that was effectively diagnosed on Gram staining. A 79-year-old woman was referred to our hospital because of swelling and pain in a left temporomandibul...
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| Published in | 日本口腔外科学会雑誌 Vol. 65; no. 5; pp. 366 - 370 |
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| Main Authors | , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
社団法人 日本口腔外科学会
20.05.2019
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| Subjects | |
| Online Access | Get full text |
| ISSN | 0021-5163 2186-1579 |
| DOI | 10.5794/jjoms.65.366 |
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| Abstract | Pseudogout is acute arthritis caused by calcium pyrophosphate dehydrate (CPPD). We report a case of pseudogout in the temporomandibular joint (TMJ) that was effectively diagnosed on Gram staining. A 79-year-old woman was referred to our hospital because of swelling and pain in a left temporomandibular lesion. Clinical and blood test findings suggested acute suppurative arthritis of the TMJ. The patient was treated with antibiotics after arthrocentesis. Bacteria was not detected on Gram staining of joint fluid, but crystal components were comfirmed. Pseudogout was diagnosed on the basis of multiple small regions of mineralization and imaging and crystal characteristics under a polarizing microscope. Symptoms were improved by nonsteroidal anti-inflammatory drugs (NSAIDs) after the cessation of antibiotics. Gram staining was a simple and quick technique that facilitated the diagnosis of temporomandibular pseudogout. |
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| AbstractList | Pseudogout is acute arthritis caused by calcium pyrophosphate dehydrate (CPPD). We report a case of pseudogout in the temporomandibular joint (TMJ) that was effectively diagnosed on Gram staining. A 79-year-old woman was referred to our hospital because of swelling and pain in a left temporomandibular lesion. Clinical and blood test findings suggested acute suppurative arthritis of the TMJ. The patient was treated with antibiotics after arthrocentesis. Bacteria was not detected on Gram staining of joint fluid, but crystal components were comfirmed. Pseudogout was diagnosed on the basis of multiple small regions of mineralization and imaging and crystal characteristics under a polarizing microscope. Symptoms were improved by nonsteroidal anti-inflammatory drugs (NSAIDs) after the cessation of antibiotics. Gram staining was a simple and quick technique that facilitated the diagnosis of temporomandibular pseudogout. |
| Author | 桝井, 敦史 鵜澤, 成一 太田, 嘉幸 永川, 賢治 |
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| References | 4) Zitnan D and Sitaj S : Chondrocalcinosis articularis Section I. clinical and radiological study. Ann Rheum Dis 22: 142-152, 1963. 12) 青山 繁， 木野孔司， 他：顎関節のピロリン酸カルシウム結晶沈着症 (偽痛風) を伴う滑膜軟骨腫症の1例．日口外誌 45: 387-389, 1999. 14) 益田郁子：偽痛風 (CPPD結晶沈着症) とその治療．綜合臨牀 59: 281-286, 2010. 1) McCarty DJ, Kohn NN, et al : The significance of calcium phosphate crystals in the synovial fluid of arthritic patients: The “pseudogout syndrome.”Ⅰ．Clinical aspects. Ann Intern Med 56: 711-737, 1962. 13) 宮本亮三， 藤井雅敏， 他：顎関節に生じたピロリン酸カルシウム結晶沈着症 (偽痛風) の1例．口科誌 57: 58-63, 2008. 3) 中川洋一， 下田信治， 他：顎関節結晶沈着症の診断とそのプロセス．日顎関節会誌 13: 282-290, 2001. 15) 服部 宇， 水谷英樹， 他：顎関節上関節腔洗浄療法にて症状寛解したピロリン酸カルシウム結晶症の１例．日口外誌 46: 490-492, 2000. 8) Nakagawa Y, Ishii H, et al : Pseudogout of the temporomandibular joint. J Oral Maxillofac Surg 28: 26-28, 1999. 7) Amir L, Peter MS, et al : Pseudogout in the temporomandibular joint with imaging, arthroscopic, operative, and pathologic findings. Report of an unusual case. American Association of Oral and Maxillofacial Surgeons 73: 1106-1112, 2015. 11) 小林紘樹， 谷川英徳， 他：グラム染色を用いた偽痛風の診断．日関節病会誌 34: 549-551, 2015. 17) Kudoh K, Kudoh T, et al : A case of tophaceous pseudogout of the temporomandibular joint extending to the base of the skull. J Oral Maxillofac Surg 46: 355-2359, 2016. 6) Osano H, Matsumoto K, et al : Calcium pyrophosphate dehydrate arthropathy with condylar destruction of the temporomandibular joint. J Oral Sci 45: 223-226, 2003. 5) 山本哲彰， 宮本郁也， 他：顎関節下関節腔に生じた偽痛風の1例．日口外誌 47: 601-605, 2011. 9) 高橋雅幸：急性化膿性顎関節炎の1例．日顎関節会誌 19: 205-209, 2007. 2) 石田 剛， 今村哲夫：結晶沈着症と関連疾患. 病理と臨床 19: 307-319, 2001. 10) 小林大輔， 重松司朗， 他：化膿性顎関節炎から波及したと思われる側頭下窩膿瘍の1例．日顎関節会誌 22: 181-184, 2010. 16) 樋口雅俊， 吉澤邦夫：パンピングマニピュレーションと咬合治療にて改善を見た顎関節偽痛風の1例．口科誌 64: 335-340, 2015. |
| References_xml | – reference: 10) 小林大輔， 重松司朗， 他：化膿性顎関節炎から波及したと思われる側頭下窩膿瘍の1例．日顎関節会誌 22: 181-184, 2010. – reference: 1) McCarty DJ, Kohn NN, et al : The significance of calcium phosphate crystals in the synovial fluid of arthritic patients: The “pseudogout syndrome.”Ⅰ．Clinical aspects. Ann Intern Med 56: 711-737, 1962. – reference: 11) 小林紘樹， 谷川英徳， 他：グラム染色を用いた偽痛風の診断．日関節病会誌 34: 549-551, 2015. – reference: 13) 宮本亮三， 藤井雅敏， 他：顎関節に生じたピロリン酸カルシウム結晶沈着症 (偽痛風) の1例．口科誌 57: 58-63, 2008. – reference: 6) Osano H, Matsumoto K, et al : Calcium pyrophosphate dehydrate arthropathy with condylar destruction of the temporomandibular joint. J Oral Sci 45: 223-226, 2003. – reference: 14) 益田郁子：偽痛風 (CPPD結晶沈着症) とその治療．綜合臨牀 59: 281-286, 2010. – reference: 12) 青山 繁， 木野孔司， 他：顎関節のピロリン酸カルシウム結晶沈着症 (偽痛風) を伴う滑膜軟骨腫症の1例．日口外誌 45: 387-389, 1999. – reference: 5) 山本哲彰， 宮本郁也， 他：顎関節下関節腔に生じた偽痛風の1例．日口外誌 47: 601-605, 2011. – reference: 7) Amir L, Peter MS, et al : Pseudogout in the temporomandibular joint with imaging, arthroscopic, operative, and pathologic findings. Report of an unusual case. American Association of Oral and Maxillofacial Surgeons 73: 1106-1112, 2015. – reference: 2) 石田 剛， 今村哲夫：結晶沈着症と関連疾患. 病理と臨床 19: 307-319, 2001. – reference: 8) Nakagawa Y, Ishii H, et al : Pseudogout of the temporomandibular joint. J Oral Maxillofac Surg 28: 26-28, 1999. – reference: 15) 服部 宇， 水谷英樹， 他：顎関節上関節腔洗浄療法にて症状寛解したピロリン酸カルシウム結晶症の１例．日口外誌 46: 490-492, 2000. – reference: 16) 樋口雅俊， 吉澤邦夫：パンピングマニピュレーションと咬合治療にて改善を見た顎関節偽痛風の1例．口科誌 64: 335-340, 2015. – reference: 9) 高橋雅幸：急性化膿性顎関節炎の1例．日顎関節会誌 19: 205-209, 2007. – reference: 3) 中川洋一， 下田信治， 他：顎関節結晶沈着症の診断とそのプロセス．日顎関節会誌 13: 282-290, 2001. – reference: 17) Kudoh K, Kudoh T, et al : A case of tophaceous pseudogout of the temporomandibular joint extending to the base of the skull. J Oral Maxillofac Surg 46: 355-2359, 2016. – reference: 4) Zitnan D and Sitaj S : Chondrocalcinosis articularis Section I. clinical and radiological study. Ann Rheum Dis 22: 142-152, 1963. |
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| Title | グラム染色が診断に有効であった顎関節偽痛風の1例 |
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