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Sembronio S, Raccampo L, Tel A, Di Cosola M, Troise S, Dell’Aversana Orabona G, Robiony M. The Role of Temporomandibular Joint Arthroscopy for Diagnosis and Surgical Management of Synovial Chondromatosis. Diagnostics (Basel) 2023; 13:2837. [PMID: 37685375 PMCID: PMC10486883 DOI: 10.3390/diagnostics13172837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Revised: 08/27/2023] [Accepted: 08/30/2023] [Indexed: 09/10/2023] Open
Abstract
OBJECTIVE We report the experience of our maxillo-facial surgery unit into the diagnostic and the therapeutic role of arthroscopy of temporomandibular joint (TMJ) synovial chondromatosis (SC). MATERIALS AND METHODS A series of sixteen patients with an imaging, arthroscopical, and histological diagnosis of SC treated with arthroscopy was selected. The surgeries were conducted in the Department of Maxillo-facial surgery, Academic hospital of Udine, from January 2016 to December 2022. Medical history, clinical examination, imaging, arthroscopical, and histological characteristics were recorded and then reviewed and discussed. RESULTS Clinical improvement, both in pain and in maximum incisal opening (MIO), were noticed in whole patients. Histologically, according to Milgram's classification, the sample was fairly homogeneous. Arthroscopic treatment was successful in 87.5% of the patients. Only two cases of SC relapse were registered and were then submitted to open surgery to perform a total sinovectomy. The data collected were used to develop an SC classification proposal based on clinical, radiological (magnetic resonance imaging), arthroscopical, and histopathological characteristics. CONCLUSIONS TMJ arthroscopy must be considered the first line of treatment for SC, leaving open surgery to relapses cases and those cases with extraarticular extension. A univocal classification is essential to best stage and prognostically characterise this pathology.
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Affiliation(s)
- Salvatore Sembronio
- Maxillofacial Surgery Department, Academic Hospital of Udine, Department of Medicine, University of Udine, Piazzale S. Maria della Misericordia 1, 33100 Udine, Italy
| | - Luca Raccampo
- Maxillofacial Surgery Department, Academic Hospital of Udine, Department of Medicine, University of Udine, Piazzale S. Maria della Misericordia 1, 33100 Udine, Italy
| | - Alessandro Tel
- Maxillofacial Surgery Department, Academic Hospital of Udine, Department of Medicine, University of Udine, Piazzale S. Maria della Misericordia 1, 33100 Udine, Italy
| | - Michele Di Cosola
- Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy
| | - Stefania Troise
- Maxillofacial Unit, Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, 80131 Naples, Italy
| | - Giovanni Dell’Aversana Orabona
- Maxillofacial Unit, Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, 80131 Naples, Italy
| | - Massimo Robiony
- Maxillofacial Surgery Department, Academic Hospital of Udine, Department of Medicine, University of Udine, Piazzale S. Maria della Misericordia 1, 33100 Udine, Italy
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Brabyn PJ, Capote A, Muñoz-Guerra MF, Zylberberg I, Rodríguez-Campo FJ, Naval-Gías L. Arthroscopic Management of Synovial Chondromatosis of the Temporomandibular Joint. Case Series and Systematic Review. J Maxillofac Oral Surg 2018; 17:401-409. [PMID: 30344377 DOI: 10.1007/s12663-018-1102-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Accepted: 03/12/2018] [Indexed: 12/19/2022] Open
Abstract
Aim Synovial chondromatosis (SC) is a benign condition that is characterized by the formation of cartilaginous nodules within the synovial tissue of a joint that may detach and form loose bodies inside the articular space. The purpose of this study is to evaluate the use of surgical arthroscopy for the treatment of SC of the temporomandibular joint (TMJ). Materials and Methods A series of six patients treated with arthroscopy (one patient requiring an open arthrotomy due to the size of the loose bodies) in our centre between 1997 and 2016 is presented and results are discussed. A systematic review of the literature of patients with SC treated with arthroscopy or arthroscopy-assisted open arthrotomy is also carried out. Results Pain, which was the main symptom in our patients, and maximum mouth opening both improved significantly after surgical treatment. Three of the patients were diagnosed with primary SC, and the other 3 had a previous diagnosis of internal derangement. None of the patients showed signs of relapse during the follow-up period. Conclusions Surgical arthroscopy is a minimally invasive procedure that allows the extraction of loose bodies and even partial synovectomy of the affected membrane with good results and without recurrence of the disease. This technique can be useful in cases of SC with loose bodies measuring less than 3 mm or without extra-articular extension.
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Affiliation(s)
- Philip James Brabyn
- 1Resident of Oral and Maxillofacial Department, Hospital Universitario La Princesa, C/Diego de León 62, 28006 Madrid, Spain
| | - Ana Capote
- 2Staff Surgeon of Oral and Maxillofacial Department, Hospital Universitario La Princesa, Madrid, Spain
| | | | - Ian Zylberberg
- 1Resident of Oral and Maxillofacial Department, Hospital Universitario La Princesa, C/Diego de León 62, 28006 Madrid, Spain
| | | | - Luis Naval-Gías
- 3Head of Oral and Maxillofacial Department, Hospital Universitario La Princesa, Madrid, Spain
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Souza DPE, Loureiro CCDS, Falchet PF, Leandro LFL, Raitz R. Synovial Chondromatosis of the Temporomandibular Joint: An Asymptomatic Case Report and Literature Review. Cranio 2014; 28:67-71. [DOI: 10.1179/crn.2010.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Synovial chondromatosis originally arising in the lower compartment of temporomandibular joint: A case report and literature review. J Craniomaxillofac Surg 2011; 39:459-62. [DOI: 10.1016/j.jcms.2010.10.012] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2010] [Revised: 08/16/2010] [Accepted: 10/04/2010] [Indexed: 11/22/2022] Open
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Gil-Salú JL, Lázaro R, Aldasoro J, Gonzalez-Darder JM. Giant solitary synovial chondromatosis of the temporomandibular joint with intracranial extension. Skull Base Surg 2011; 8:99-104. [PMID: 17171059 PMCID: PMC1656687 DOI: 10.1055/s-2008-1058583] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Synovial chondromatosis are rare entities but are well-described lesions in the literature that can affect many joint areas of the body. A case of tumoral synovial chondromatosis involving the temporomandibular joint with intracranial extension through mandibular fossa is reported. As long as there was significant infratemporal and extradural invasion of the middle and posterior fossa, a transtemporal and infratemporal approach was performed and total removal of the lesions was achieved. A brief review of skull base synovial chondromatosis is presented.
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6
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Shah SB, Ramanojam S, Gadre PK, Gadre KS. Synovial chondromatosis of temporomandibular joint: journey through 25 decades and a case report. J Oral Maxillofac Surg 2011; 69:2795-814. [PMID: 21470750 DOI: 10.1016/j.joms.2010.12.029] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2010] [Accepted: 12/28/2010] [Indexed: 02/03/2023]
Affiliation(s)
- Shishir B Shah
- Department of Oral and Maxillofacial Surgery, Bharati Vidyapeeth Dental College and Hospital, Pune, Maharashtra, India.
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Ida M, Yoshitake H, Okoch K, Tetsumura A, Ohbayashi N, Amagasa T, Omura K, Okada N, Kurabayashi T. An investigation of magnetic resonance imaging features in 14 patients with synovial chondromatosis of the temporomandibular joint. Dentomaxillofac Radiol 2008; 37:213-9. [PMID: 18460574 DOI: 10.1259/dmfr/95185114] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES To show the characteristic MRI features of synovial chondromatosis (SC) of the temporomandibular joint (TMJ). METHODS All patients with histologically proven SC of the TMJ who underwent MRI at our clinic were examined. In 14 patients (male-to-female ratio, 2:12; average age 46+/-14 years), clinical and conventional radiographic findings were reviewed. In addition, the MRI findings of articular disc and condyle position, shape and signal intensity of the joint spaces, and bone changes of surrounding structures were analysed. RESULTS The main symptoms were pain (in 93% of the patients) and limitation of mouth opening (64%). Two cases showed typical multiple calcifications around the TMJ on conventional radiography. On MRI, the disc position was normal in 12 (86%) patients and the condyle was inferiorly displaced in 9 (64%) patients. 11 (79%) patients showed enlargement of the joint space, with either a "dumbbell" shape or bulging. SC in the upper compartment showed various degrees of bone changes of the articular eminence and fossa. SC in the lower compartment showed concavity or hypertrophy of the condyle. The severity of the bone changes progressed with duration of symptoms. CONCLUSIONS About 0.3% of the patients complaining of TMJ pain and dysfunction were found to have SC. There was great variation in the MRI features of the TMJs with SC. More severe destruction of surrounding bone structures with features resembling a tumour were found in patients with a longer duration of symptoms.
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Affiliation(s)
- M Ida
- Oral and Maxillofacial Radiology, Division of Oral Health Sciences, Graduate School, Tokyo Medical and Dental University, 5-45 Yushima 1-chome, Bunkyo-ku, Tokyo 1138549, Japan.
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9
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Lieger O, Zix J, Stauffer-Brauch EJ, Iizuka T. Synovial Chondromatosis of the Temporomandibular Joint With Cranial Extension: A Case Report and Literature Review. J Oral Maxillofac Surg 2007; 65:2073-80. [PMID: 17884541 DOI: 10.1016/j.joms.2006.04.039] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2005] [Revised: 12/15/2005] [Accepted: 04/05/2006] [Indexed: 10/22/2022]
Affiliation(s)
- Olivier Lieger
- Department of Cranio-Maxillofacial Surgery, University of Bern, Bern, Switzerland.
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10
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Shibuya T, Kino K, Yoshida S, Amagasa T. Arthroscopic removal of nodules of synovial chondromatosis of the temporomandibular joint. Cranio 2002; 20:304-6. [PMID: 12403189 DOI: 10.1080/08869634.2002.11746223] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
In this report we describe a new method for removing nodules of TMJ synovial chondromatosis using arthroscopic surgery instead of open surgery. We used two steps during arthroscopy. In the first, we lavaged the cavity with sterile saline. In the next step, the second cannula was replaced with ethmoid forceps. Under arthroscopic guidance through the first cannula, all loose bodies were removed using the forceps. Since the loose bodies are not fragmented during this procedure, the time needed for removal is shortened. Based on this experience, we suggest the use of ethmoid forceps should be considered as an alternative procedure when nodules are unable to pass through the cannula by lavage with sterile saline.
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Affiliation(s)
- Tomoaki Shibuya
- Dept. of Maxillofacial Surgery, Graduate School, Tokyo Medical and Dental University, Japan
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11
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von Lindern JJ, Theuerkauf I, Niederhagen B, Bergé S, Appel T, Reich RH. Synovial chondromatosis of the temporomandibular joint: clinical, diagnostic, and histomorphologic findings. ORAL SURGERY, ORAL MEDICINE, ORAL PATHOLOGY, ORAL RADIOLOGY, AND ENDODONTICS 2002; 94:31-8. [PMID: 12193890 DOI: 10.1067/moe.2002.123498] [Citation(s) in RCA: 72] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Objective. The primary diagnosis of synovial chondromatosis of the temporomandibular joint is extremely rare. Often many months, or even years pass before the diagnosis is confirmed. Study Design. Eight patients with synovial chondromatosis were treated by arthrotomy. In addition to the definitive diagnosis, histologic classification according to the stages proposed by Milgram was undertaken and confirmed with the literature. Results. The predominant symptoms of synovial chondromatosis, including pain, swelling, restricted movement of the mandible, and crepitation, were evaluated. Nevertheless, more than 80% of the patients were previously primarily treated on the basis of other tentative diagnoses. Conclusion. Synovial chondromatosis of the temporomandibular joint should be included in the differential diagnosis of chronic swelling and pain in the preauricular region, and the patient should be sent for appropriate diagnostics and therapy at an early stage.
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Affiliation(s)
- Jens J von Lindern
- Department of Oral and Maxillofacial Surgery, University of Bonn, Sigmund Freud Strasse 25, D-53105 Bonn, Germany.
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12
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Klenoff JR, Lowlicht RA, Lesnik T, Sasaki CT. Mandibular and temporomandibular joint arthropathy in the differential diagnosis of the parotid mass. Laryngoscope 2001; 111:2162-5. [PMID: 11802017 DOI: 10.1097/00005537-200112000-00016] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To increase awareness of temporomandibular joint and mandibular disease in the overall evaluation and diagnosis of the parotid mass. STUDY DESIGN We describe clinical presentations of pigmented villonodular synovitis and synovial chondrocalcinosis of the temporomandibular joint, as well as osteoma of the mandible, as they may initially suggest primary neoplasms of the parotid gland. CONCLUSIONS Preauricular swelling is a common presenting symptom for patients visiting an otolaryngologist. Often this symptom is suggestive of a parotid mass. However, lesions of the temporomandibular joint and mandible may also present in this fashion.
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Affiliation(s)
- J R Klenoff
- Section of Otolaryngology, Yale University School of Medicine, New Haven, Connecticut, USA
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13
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Alptekin K, Degirmenci B, Kivircik B, Durak H, Yemez B, Derebek E, Tunca Z. Tc-99m HMPAO brain perfusion SPECT in drug-free obsessive-compulsive patients without depression. Psychiatry Res 2001; 107:51-6. [PMID: 11472864 DOI: 10.1016/s0925-4927(01)00086-5] [Citation(s) in RCA: 79] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The aim of this study was to confirm prior results of brain-imaging studies on obsessive-compulsive disorder (OCD) in a sample of Turkish patients, as a cross-cultural study. Tc-99m HMPAO brain perfusion SPECT imaging was performed in nine drug-free OCD patients without depression and six controls. The patients' Hamilton Depression Rating Scale scores were <16. The severity of obsessive-compulsive symptoms was rated with the Yale-Brown Obsessive-Compulsive Rating Scale (YBOCS). Quantitative evaluation of regional cerebral blood flow revealed that right thalamus, left frontotemporal cortex and bilateral orbitofrontal cortex showed significant hyperperfusion in patients with OCD compared with controls. YBOCS scores did not show any correlation with hyperperfusion in regional cerebral blood flow in these areas. Results of this cross-cultural study may support orbitofrontal and thalamic dysfunction in OCD in a sample of Turkish patients.
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Affiliation(s)
- K Alptekin
- Department of Psychiatry, School of Medicine, University of Dokuz Eylül, 35340, Balçova-Izmir, Turkey.
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14
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Gay-Escoda C, Valmaseda-Castellón E, Alaejos-Algarra C, Vázquez-Rodriguez E. Condylar hyperplasia associated to synovial chondromatosis of the temporomandibular joint: a case report. Cranio 2001; 19:91-5. [PMID: 11842870 DOI: 10.1080/08869634.2001.11746157] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Condylar hyperplasia is a slowly developing malformation of the mandible, with elongation of the mandibular neck, that generally results in facial asymmetry. Synovial chondromatosis is a benign chronic disorder characterized by the formation of multiple small nodules of hyaline cartilage as a result of metaplasia of the synovial connective tissue. It affects mostly the large joints, particularly the knee, hip, elbow and ankle. The temporomandibular joint (TMJ) is rarely affected. The case of a 42-year-old male with a history of left preauricular pain and swelling and deviation of the mandible to the left upon opening the mouth is presented. Computed tomography disclosed hyperplasia of the left condyle with loose radiopaque bodies within the joint cavity. The left TMJ was subject to open surgery, which included resection of four loose bodies and a remodeling condylectomy. The histopathological study confirmed the diagnosis of condylar hyperplasia and chondromatosis of the left TMJ.
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Affiliation(s)
- C Gay-Escoda
- Dental School of the University of Barcelona, Spain
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15
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Reddy PK, Vannemreddy PS, Gonzalez E, Nanda A. Synovial chondromatosis of the temporomandibular joint with intracranial extension. J Clin Neurosci 2000; 7:332-4. [PMID: 10938614 DOI: 10.1054/jocn.1999.0214] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
We present a rare case of synovial chondromatosis of the left temporomandibular joint with intracranial extension and review the relevant literature. This is the sixth published report of such a skull base tumour. We discuss imaging characteristics and the differential diagnosis with regards to a curative surgical resection.
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Affiliation(s)
- P K Reddy
- Department of Neurosurgery, Louisiana State University Medical Center, Shreveport, LA 71130-3932, USA
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16
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Miyamoto H, Sakashita H, Wilson DF, Goss AN. Synovial chondromatosis of the temporomandibular joint. Br J Oral Maxillofac Surg 2000; 38:205-8. [PMID: 10864727 DOI: 10.1054/bjom.1999.0181] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
We report two cases of temporomandibular joint (TMJ) synovial chondromatosis, one of which was in the early stage and treated arthroscopically. The second was more advanced and recurred after removal of the free bodies, and so required condylectomy and synovectomy.
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Affiliation(s)
- H Miyamoto
- Oral & Maxillofacial Surgery Unit, Fujieda Municipal General Hospital, Fujieda, Shizuoka, Japan
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17
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Karlis V, Glickman RS, Zaslow M. Synovial chondromatosis of the temporomandibular joint with intracranial extension. ORAL SURGERY, ORAL MEDICINE, ORAL PATHOLOGY, ORAL RADIOLOGY, AND ENDODONTICS 1998; 86:664-6. [PMID: 9868721 DOI: 10.1016/s1079-2104(98)90200-1] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
An unusual case of synovial chondromatosis of the temporomandibular joint with intracranial extension, which resulted in complete dehiscence of the floor of the middle cranial fossa, is reported. An overview of the current literature and a discussion of the diagnosis and surgical management of synovial chondromatosis are presented.
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Affiliation(s)
- V Karlis
- New York University College of Dentistry, Dept. of Oral and Maxillofacial Surgery, New York, New York 10010, USA
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18
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Louis PJ, West WF, Tilley MS, Waite PD, Cuzalina LA. A case report. Chondromatosis of the temporomandibular joint. J Am Dent Assoc 1998; 129:1010-3. [PMID: 9685766 DOI: 10.14219/jada.archive.1998.0355] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Synovial chondromatosis is a rare pathological condition that usually affects large joints but can affect the temporomandibular joint. The disease typically manifests itself with signs and symptoms similar to internal derangement. The disease is characterized by free-floating or attached cartilaginous bodies in the joint space. In this article, the authors present a case of synovial chondromatosis and discuss its pathological process. They also discuss diagnostic approaches and current treatment.
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Affiliation(s)
- P J Louis
- University of Alabama at Birmingham, School of Dentistry, Department of Oral and Maxillofacial Surgery 35294-0007, USA
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19
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Ikebe T, Nakayama E, Shinohara M, Takeuchi H, Takenoshita Y. Synovial chondromatosis of the temporomandibular joint: the effect of interleukin-1 on loose-body-derived cells. ORAL SURGERY, ORAL MEDICINE, ORAL PATHOLOGY, ORAL RADIOLOGY, AND ENDODONTICS 1998; 85:526-31. [PMID: 9619668 DOI: 10.1016/s1079-2104(98)90285-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE The purpose of this study was to investigate the effect of interleukin-1 on cells from loose bodies of synovial chondromatosis of the temporomandibular joint. STUDY DESIGN The cells were isolated from uncalcified loose bodies in a case of synovial chondromatosis of the temporomandibular joint and cultured in alpha-MEM medium containing 10% fetal bovine serum. The cells were treated with or without interleukin-1alpha and then stained with toluidine blue. Their conditioned media were analyzed with gelatin zymography to detect matrix-degrading proteinase(s). RESULTS The cells from loose bodies produced toluidine-blue-stained matrix. When the cells were treated with 100 ng/ml of interleukin-1alpha for 3 days, toluidine-blue-stained matrix was strikingly reduced. Gelatin zymography revealed that interleukin-1alpha-treated cells released 62-kDa gelatinase. CONCLUSIONS Interleukin-1alpha may lead loose-body-derived cells to degrade the cartilaginous matrix of loose bodies in synovial chondromatosis of the temporomandibular joint.
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Affiliation(s)
- T Ikebe
- Second Department of Oral and Maxillofacial Surgery, Kyushu University School of Dentistry, Fukuoka, Japan
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20
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Plath T, Dallenbach H, Ohnesorge I, Hoffmeister B. [Synovial chondromatosis (chondrometaplasia). Contribution to the differential diagnosis of temporomandibular joint diseases]. MUND-, KIEFER- UND GESICHTSCHIRURGIE : MKG 1997; 1:349-52. [PMID: 9490221 DOI: 10.1007/bf03043582] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
A rare case of synovial chondromatosis of the temporomandibular joint with unspecific symptoms is presented. This causes difficulties in classifying the different clinically and technically acquired features at differential diagnosis. The concept of chondrometaplasia as being triphasic and self-limiting is strongly supported and extreme care should be taken during therapy in order to avoid any unnecessary destruction and mutilation. This case seems to indicate that chronic parafunctional overload was the initiating stimulus for this reactive metaplastic process. Nonphysiologic overstrain of any cause should be diagnosed and corrected.
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Affiliation(s)
- T Plath
- Klinik für Kieferchirurgie und Plastische Gesichtschirurgie, Klinikum Benjamin Franklin, Freie Universtität Berlin
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Lucas JH, Quinn P, Foote J, Baker S, Bruno J. Recurrent synovial chondromatosis treated with meniscectomy and synovectomy. ORAL SURGERY, ORAL MEDICINE, ORAL PATHOLOGY, ORAL RADIOLOGY, AND ENDODONTICS 1997; 84:253-8. [PMID: 9377187 DOI: 10.1016/s1079-2104(97)90339-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Synovial chondromatosis is a rare benign intraarticular metaplasia of synovium. This process may result in the production of detached particles of highly cellular cartilage in the involved joint spaces. It is most often reported in the larger joints of the body including the knee, hip, elbow, and ankle. Since Axhausen in 1993 reported the first case affecting the temporomandibular joint, several articles have been listed in the literature regarding the presentation, diagnosis, and management of this form of an arthropathy. This is a case of a recurrent synovial chondromatosis that was approached with a meniscectomy and a complete synovectomy.
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Affiliation(s)
- J H Lucas
- Department of Oral and Maxillofacial Surgery, University of Pennsylvania Medical Center, Philadelphia, USA
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Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 29-1996. A 59-year-old man with gout and a painful preauricular mass. N Engl J Med 1996; 335:876-81. [PMID: 8778607 DOI: 10.1056/nejm199609193351208] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
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23
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Miyamoto H, Sakashita H, Miyata M, Kurita K. Arthroscopic diagnosis and treatment of temporomandibular joint synovial chondromatosis: report of a case. J Oral Maxillofac Surg 1996; 54:629-31. [PMID: 8632250 DOI: 10.1016/s0278-2391(96)90648-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
- H Miyamoto
- Department of Dentistry and Oral Surgery, Ishikawa Prefectural Central Hospital, Kanazawa, Japan
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