The synovial chondromatosis of the temporomandibular joints: review of the 4 cases

Abstract

J Korean Assoc Oral Maxillofac Surg 2010;36:134-40) Synovial condromatosis of the temporomandibular joint (TMJ) is characterized by the presence of loose bodies (joint mices). It can be confused with temporomandibular disorder clinically, and be with chondrosarcoma histologically. The purpose of this clinical report was to review the clinical, radiological, arthroscopic findings, histological feature and the results of surgical treatment of TMJ synovial chondromatosis. Four patients presented with pain of TMJ and limited mouth opening. The dynamic magnetic resonance imaging (MRI) disclosed a ch aracteristic morphologic changes and displacement of the meniscus with limited translation of the condyle head. Bone scans showed progressiv e resorptive changes with hot-uptake of the radioisotope. The synovial loose bodies in the joint spaces were removed and sent to pathology for diagnosis as the synovial chondromatosis. The follow-up examination with computed tomography (CT) and MRI revealed no evidence of recurrence and good in function until postoperative 1 8 months. Diagnostically, the distension of the lateral capsule and fluid findings in the joint on the MRI are very suggestive tool for t his synovial chondromato- sis, but they are not always detected on the preoperative MRI. Arthroscopic approaches are very useful to inspect the joint spa ces and to remove the loose bodies without interruption of the whole synovial membranes.