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

Published:September 14, 2022DOI:https://doi.org/10.1016/j.oooo.2022.09.005

      Highlights

      • TMJ synovial chondromatosis is an extremely rare disease, prevalent in middle-aged women. Its differential diagnosis is difficult due to common clinical features such as swelling, pain and limited jaw movements. Treatment is surgical involving removal of cartilaginous bodies and synovectomy.

      Abstract

      Synovial chondromatosis of the temporomandibular joint 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, as 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. MRI 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 anatomopathological. Postoperative follow-up is necessary due to the risk of recurrence.

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