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

Oral Surg Oral Med Oral Pathol Oral Radiol. 2023 May;135(5):e94-e101. doi: 10.1016/j.oooo.2022.09.005. Epub 2022 Sep 15.

Abstract

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.

Publication types

  • Case Reports

MeSH terms

  • 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