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1.
Pathol Oncol Res ; 30: 1611454, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38505147

RESUMO

Introduction: Apatite rheumatism (AR), chondrocalcinosis (Ch-C), and primary synovial chondromatosis (prSynCh) are regarded as distinct clinical entities. The introduction of the non-staining technique by Bély and Apáthy (2013) opened a new era in the microscopic diagnosis of crystal induced diseases, allowing the analysis of MSU (monosodium urate monohydrate) HA (calcium hydroxyapatite), CPPD (calcium pyrophosphate dihydrate) crystals, cholesterol, crystalline liquid lipid droplets, and other crystals in unstained sections of conventionally proceeded (aqueous formaldehyde fixed, paraffin-embedded) tissue samples. The aim of this study was to describe the characteristic histology of crystal deposits in AR, Ch-C, and prSynCh with traditional stains and histochemical reactions comparing with unstained tissue sections according to Bély and Apáthy (2013). Patients and methods: Tissue samples of 4 with apatite rheumatism (Milwaukee syndrome), 16 with chondrocalcinosis, and 20 with clinically diagnosed primary synovial chondromatosis were analyzed. Results and conclusion: Apatite rheumatism, chondrocalcinosis, and primary synovial chondromatosis are related metabolic disorders with HA and CPPD depositions. The authors assume that AR and Ch-C are different stages of the same metabolic disorder, which differ from prSynCh in amorphous mineral production, furthermore in the production of chondroid, osteoid and/or bone. prSynCh is a defective variant of HA and CPPD induced metabolic disorders with reduced mineralization capabilities, where the deficient mineralization is replaced by chondroid and/or bone formation. The non-staining technique of Bély and Apáthy proved to be a much more effective method for the demonstration of crystals in metabolic diseases than conventional stains and histochemical reactions.


Assuntos
Condrocalcinose , Condromatose Sinovial , Doenças Metabólicas , Doenças Reumáticas , Humanos , Condrocalcinose/diagnóstico , Condrocalcinose/patologia , Apatitas
2.
Int J Oral Maxillofac Surg ; 53(4): 311-318, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-37840000

RESUMO

Synovial chondromatosis (SC) of the temporomandibular joint (TMJ) is a rare benign disease associated with the formation of multiple cartilaginous nodules in the synovial tissue of the TMJ. This can result in pain, swelling, clicking, limited mouth opening, and osseous degenerative joint changes. A retrospective cross-sectional study was performed to summarize the clinical features, radiographic findings, and surgical and histopathological findings of TMJ SC patients who underwent open surgery over a 24-year period. A radiographic scoring system was used to evaluate osseous changes and correlate condyle and joint fossa degeneration. The study included 38 patients and focused on 38 joints. All 38 of these joints showed degenerative changes in the condyle, while 37 showed osseous degenerative changes in the articular fossa. The degree of condylar degenerative changes was related to the duration of the chief complaints (r = 0.342, P = 0.036) and the histopathological stage of the TMJ SC (r = 0.440, P = 0.006), while the degree of joint fossa degenerative changes was associated with the radiographic extent of the SC (r = 0.504, P = 0.001), type of calcification (r = 0.365, P = 0.024), and the histopathological stage (r = 0.458, P = 0.004).


Assuntos
Condromatose Sinovial , Transtornos da Articulação Temporomandibular , Humanos , Transtornos da Articulação Temporomandibular/diagnóstico por imagem , Transtornos da Articulação Temporomandibular/cirurgia , Transtornos da Articulação Temporomandibular/complicações , Condromatose Sinovial/diagnóstico por imagem , Condromatose Sinovial/cirurgia , Estudos Retrospectivos , Estudos Transversais , Articulação Temporomandibular/diagnóstico por imagem , Articulação Temporomandibular/patologia , Côndilo Mandibular/diagnóstico por imagem , Côndilo Mandibular/cirurgia , Côndilo Mandibular/patologia
3.
Artigo em Inglês | MEDLINE | ID: mdl-38158268

RESUMO

OBJECTIVE: Herein, we aimed to study the clinical, radiographical, and histopathologic features of synovial chondromatosis in the temporomandibular joint (SC in TMJ) and provide references for early diagnosis and treatment prognosis. STUDY DESIGN: The medical records and imaging examinations of patients with SC in TMJ, diagnosed using postoperative histopathologic examination, were reviewed and analyzed. Among them, 18 cases who lacked calcified loose bodies on spiral computed tomography or cone beam computed tomography (SCT/CBCT) were selected for further study. Descriptive statistical methods were used to analyze the clinical characteristics of patients. RESULTS: The study included 100 patients with SC in TMJ, who were predominantly female (male to female: 1:3), and were aged from 21 to 77 years (median, 47). Radiopaque calcified lesions on SCT/CBCT were missing in 18 cases, but cartilaginous nodules were observed during surgery. The cases lacking calcification had a relatively shorter disease course, suggesting they were in the early stages of SC. CONCLUSION: In the early stage of SC, although calcified loose bodies cannot be detected on SCT/CBCT, attention should be paid to the widening of the posterior superior joint space and sclerosis or slight erosion of the joint fossa. Magnetic resonance imaging would be helpful to detect the early-stage SC in TMJ.


Assuntos
Condromatose Sinovial , Humanos , Feminino , Masculino , Condromatose Sinovial/diagnóstico por imagem , Condromatose Sinovial/cirurgia , Estudos Retrospectivos , Articulação Temporomandibular/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Progressão da Doença
4.
Int Immunopharmacol ; 127: 111416, 2024 Jan 25.
Artigo em Inglês | MEDLINE | ID: mdl-38145599

RESUMO

BACKGROUND: Synovial chondromatosis (SC) primarily affects the major joints and is characterized by the formation of benign cartilaginous nodules. In the present study, we evaluated the differences in the histology and gene expression of SC and normal cartilages and further elucidated the function of hub genes in SC. METHODS: Histological staining and biochemical analysis were performed to measure collagen and glycosaminoglycan (GAG) contents in SC and normal cartilage samples. Then, microarray analysis was performed using knee joint samples (three normal and three SC samples) to identify the differentially expressed genes (DEGs). Subsequently, bioinformatics analysis was performed to identify the hub genes and explore the mechanisms underlying SC. The intersection of the top 10 upregulated DEGs, top 10 downregulated DEGs, and hub genes was validated in SC tissues. Lastly, in vitro experiments and our clinical cohort were used to determine the potential biological functions and diagnostic value, respectively, of the most significant gene. RESULTS: The GAG and collagen contents were comparable to or higher in SC tissues than in normal tissues. Microarray analysis revealed 143 upregulated and 107 downregulated DEGs in SC. Furthermore, functional enrichment analysis revealed an association between immunity and metabolism-related pathways and SC development. Among 20 hub genes, two intersection genes, namely, collagen type III alpha 1 chain (COL3A1) and HSPA8, were notably expressed in SC tissues, with COL3A1 exhibiting a more significant difference in mRNA expression. Furthermore, COL3A1 can promote chondrocyte migration and cell cycle progression. Additionally, clinical data revealed COL3A1 can be a diagnostic marker for primary SC (AUC = 0.82) and be a positive correlation with neutrophil-to-lymphocyte ratio. CONCLUSIONS: These results suggest that SC tissues contained the abundant GAG and collagen. COL3A1 can affect the function of chondrocytes and be a diagnostic marker of primary SC patients. These findings provide a novel approach and a fundamental contribution for diagnosis and treatment in SC.


Assuntos
Condrócitos , Condromatose Sinovial , Humanos , Condrócitos/patologia , Condromatose Sinovial/patologia , Biomarcadores , Ciclo Celular/genética , Colágeno , Biologia Computacional/métodos , Colágeno Tipo III
7.
Rev Med Liege ; 78(10): 533-534, 2023 Oct.
Artigo em Francês | MEDLINE | ID: mdl-37830315

RESUMO

Synovial chondromatosis is a rare pathology that involves most frequently the weight-bearing joints. It is due to the development of cartilaginous bodies from the synovial membrane that could migrate threw the joint. Primary and secondary forms exist. Clinical examination will be marked by swellings and loss of mobility. Cross-sectional imaging has the preference. The treatment of choice is the removal of cartilaginous loose bodies with or without a synovectomy.


L'ostéochondromatose synoviale est une pathologie rare touchant plus fréquemment les articulations en charge. Il s'agit du développement de corps cartilagineux à partir de la membrane synoviale, pouvant devenir intra-articulaires. Il existe des formes primaires et secondaires. L'examen clinique sera principalement marqué par des épanchements et des limitations d'amplitudes articulaires. L'imagerie de choix sera l'imagerie en coupes. Le traitement de choix est l'exérèse des corps cartilagineux sous arthroscopie associée à une synovectomie.


Assuntos
Condromatose Sinovial , Corpos Livres Articulares , Humanos , Condromatose Sinovial/diagnóstico por imagem , Condromatose Sinovial/cirurgia , Sinovectomia
8.
JBJS Case Connect ; 13(3)2023 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-37478321

RESUMO

CASE: Synovial chondromatosis is a rare condition affecting synovial joints. It occurs uncommonly in the shoulder and is rare in the pediatric population. We present a case of a 13-year-old male patient with shoulder pain who was diagnosed with synovial chondromatosis and a posterior labral tear. He was treated with arthroscopic loose body removal, synovectomy, and posterior labral repair and recovered well from the surgery. Four years after the surgery, he developed pain in the same shoulder, but the cause of the pain was not investigated per the patient's decision. CONCLUSION: Synovial chondromatosis should be considered in pediatric patients presenting with shoulder pain and loss of function with potential for recurrence.


Assuntos
Condromatose Sinovial , Articulação do Ombro , Adolescente , Humanos , Masculino , Artroscopia , Condromatose Sinovial/complicações , Condromatose Sinovial/diagnóstico por imagem , Condromatose Sinovial/cirurgia , Ombro , Articulação do Ombro/cirurgia , Dor de Ombro/etiologia , Dor de Ombro/cirurgia
9.
Artigo em Inglês | MEDLINE | ID: mdl-37321929

RESUMO

This case series reviews 2 patients worked up and treated for unilateral synovial chondromatosis of the temporomandibular joint (TMJ). The first was a 58-year-old female evaluated and treated for synovial chondromatosis of the left TMJ using an arthrotomy of the joint to remove the cartilaginous and osteocartilaginous nodules. The second is a 63-year-old male who was evaluated and treated for synovial chondromatosis of the right TMJ with the removal of extracapsular masses and an arthrotomy with intra-joint removal of nodules. Six-year radiographic follow-up demonstrated no recurrence of the pathology in his case. The cases are reviewed in this article, along with a current review of the literature.


Assuntos
Condromatose Sinovial , Transtornos da Articulação Temporomandibular , Masculino , Feminino , Humanos , Pessoa de Meia-Idade , Condromatose Sinovial/diagnóstico por imagem , Condromatose Sinovial/cirurgia , Condromatose Sinovial/patologia , Transtornos da Articulação Temporomandibular/diagnóstico por imagem , Transtornos da Articulação Temporomandibular/cirurgia , Transtornos da Articulação Temporomandibular/patologia , Articulação Temporomandibular/patologia
10.
BMC Musculoskelet Disord ; 24(1): 251, 2023 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-37005684

RESUMO

BACKGROUND: Synovial chondromatosis is an uncommon metaplastic process of the synovial lining that results in the formation of cartilaginous nodules within joints or their associated bursae or tendon sheaths. Radiologic evidence of mineralized bodies within these structures is typically pathognomonic for this condition. Extraarticular chondromatosis is rarer than intraarticular chondromatosis, and the knee is affected less frequently than the smaller joints of the hands and feet. To our knowledge, no reports describing this condition in the semimembranosus-medial collateral ligament (SM-MCL) bursa have been published. CASE PRESENTATION: We describe a case of tenosynovial chondromatosis in a 37-year-old woman. The case was atypical for both the location within the SM-MCL bursa and the paucity of radiodense or hypointense changes to support a clinical suspicion of chondroid metaplasia on radiographs and T2-weighted MRI, respectively. Recreational weightlifting and swimming by the patient were impaired by chronic pain, and restricted range of motion of the ipsilateral knee persisted despite extensive skilled physical therapy and injections of both corticosteroids and platelet-rich plasma. Thirteen months after a diagnostic and therapeutic knee arthroscopy, open surgical excision of the SM-MCL bursal body was performed, and knee pain and range of motion improved by the 6-week postoperative reevaluation. Pathologic evaluation of the excised tissue was consistent with tenosynovial chondromatosis. CONCLUSIONS: Synovial chondromatosis should be considered in the differential diagnosis for recalcitrant bursitis, even in the absence of classic imaging findings.


Assuntos
Condromatose Sinovial , Condromatose , Ligamentos Colaterais , Músculos Isquiossurais , Feminino , Humanos , Adulto , Condromatose Sinovial/diagnóstico por imagem , Condromatose Sinovial/cirurgia , Imageamento por Ressonância Magnética/métodos
11.
Hand Surg Rehabil ; 42(3): 258-260, 2023 06.
Artigo em Inglês | MEDLINE | ID: mdl-36933830

RESUMO

We report the case of an 80-year-old woman who presented with an asymptomatic slowly growing mass in the dorsal aspect of her right wrist. Radiographs revealed a snail-shaped radiopaque structure. Surgical exploration and excision revealed a calcified lesion over the extensor digitorum communis. Histopathological analysis confirmed the diagnosis of tenosynovial chondromatosis. At the last follow-up, four years after surgery, the patient was asymptomatic and free of recurrence. Practitioners and hand surgeons should be aware of the dorsal involvement and evocative radiological calcifications of tenosynovial chondromatosis, which is a rare benign soft tissue neoplasm that affects all tendon sheaths of the hand.


Assuntos
Condromatose Sinovial , Condromatose , Neoplasias de Tecidos Moles , Humanos , Feminino , Idoso de 80 Anos ou mais , Punho , Condromatose/patologia , Condromatose Sinovial/diagnóstico por imagem , Condromatose Sinovial/cirurgia , Articulação do Punho/diagnóstico por imagem , Articulação do Punho/cirurgia , Neoplasias de Tecidos Moles/diagnóstico por imagem , Neoplasias de Tecidos Moles/cirurgia , Neoplasias de Tecidos Moles/patologia
13.
Clin Orthop Surg ; 15(1): 118-126, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36779001

RESUMO

Background: Synovial osteochondromatosis (SOC) of the shoulder is a rare condition with unclear characteristics. This study evaluated the clinical features and postoperative functional outcomes of SOC of the shoulder that are distinct from SOC of other joints. Methods: The characteristics of 28 shoulders with SOC that underwent arthroscopy were retrospectively assessed. Ten shoulders (35.7%) had rotator cuff tears (RCTs) and underwent concomitant arthroscopic rotator cuff repair. The mean follow-up period was 83.6 months (range, 24-154 months). Demographic characteristics and loose bodies localized under arthroscopy were compared between cases with and without concomitant RCTs. Radiography, ultrasonography, or magnetic resonance imaging were performed preoperatively and postoperatively. Visual analog scale (VAS) scores for pain and satisfaction were evaluated for all cases, and functional scores were assessed in shoulders with concomitant RCTs. Results: The average age was 36.2 ± 15.6 years among patients without RCTs and 58.3 ± 7.2 years among patients with RCTs. Seven shoulders (7%) had osteoarthritis. Arthroscopy revealed loose bodies in multiple spaces, including the glenohumeral joint, subacromial (SA) space, and biceps tendon sheath. Overall, loose bodies were found in multiple spaces in 12 shoulders (42.9%). Loose bodies were found in the SA space only in 4 shoulders (22.2%) without RCTs and in 7 shoulders (70.0%) with RCTs. VAS for pain decreased significantly from 3.9 ± 2.3 to 1.1 ± 1.3 (p < 0.001). The functional scores increased significantly after arthroscopic management for patients with concurrent RCTs (all p < 0.05). Recurrence of SOC occurred in 3 of the 22 shoulders (13.6%) who underwent postoperative imaging, but no patient had a recurrent RCT. Conclusions: Pain relief and patient satisfaction were achieved via arthroscopic management. Unlike in other joints, loose bodies can occur simultaneously in several spaces in the shoulder, including the glenohumeral joint, SA space, and biceps tendon sheath. Early diagnosis of SOC of the SA space can help prevent osteoarthritis and RCT progression.


Assuntos
Condromatose Sinovial , Osteoartrite , Lesões do Manguito Rotador , Articulação do Ombro , Humanos , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Ombro/cirurgia , Manguito Rotador/cirurgia , Condromatose Sinovial/diagnóstico por imagem , Condromatose Sinovial/cirurgia , Resultado do Tratamento , Lesões do Manguito Rotador/cirurgia , Articulação do Ombro/cirurgia , Artroscopia/métodos , Dor
14.
Artigo em Inglês | MEDLINE | ID: mdl-36828757

RESUMO

OBJECTIVE: Synovial chondromatosis (SC) of the temporomandibular joint (TMJ) is a synovial membrane disease characterized by the formation of cartilaginous nodules (CN), that may erode the skull base. Historically, cases with skull base involvement have been treated with open surgery. We report a case of TMJ SC with skull base perforation treated and repaired via minimally invasive TMJ arthroscopy and describe the advanced endoscopic operative maneuvers performed. CASE REPORT: A 34-year-old male presented with a 4-year history of malocclusion and right TMJ arthralgia. Clinical examination demonstrated malocclusion and direct pressure loading pain. Advanced imaging revealed glenoid fossa erosion and numerous homogenous hypointense lesions within an effusion. The initial surgical plan included diagnostic TMJ arthroscopy followed by conversion to open arthroplasty. Endoscopic operative maneuvers allowed for the accomplishment of the surgical goals, completely arthroscopically. Histopathology confirmed SC, and the patient remains on observation, with relief of symptoms. CONCLUSION: Advanced arthroscopy is a viable treatment option for select cases of TMJ SC with skull base involvement that allowed for access to the joint space, retrieval of biopsy specimens and CN, and repair of the skull defect.


Assuntos
Condromatose Sinovial , Transtornos da Articulação Temporomandibular , Masculino , Humanos , Adulto , Condromatose Sinovial/diagnóstico por imagem , Condromatose Sinovial/cirurgia , Condromatose Sinovial/patologia , Transtornos da Articulação Temporomandibular/diagnóstico por imagem , Transtornos da Articulação Temporomandibular/cirurgia , Transtornos da Articulação Temporomandibular/patologia , Tomografia Computadorizada por Raios X , Articulação Temporomandibular/patologia , Base do Crânio/patologia , Base do Crânio/cirurgia
16.
QJM ; 116(2): 138, 2023 02 24.
Artigo em Inglês | MEDLINE | ID: mdl-36218922
17.
Curr Rheumatol Rev ; 19(3): 362-366, 2023 Jun 05.
Artigo em Inglês | MEDLINE | ID: mdl-36221868

RESUMO

BACKGROUND: Synovial chondromatosis is an uncommon benign condition characterized by synovial membrane proliferation and metaplasia. Synovial chondromatosis cases in patients with rheumatoid arthritis have been reported. However, involvement of the glenohumeral joint is rare. CASE PRESENTATION: We herein report a case of a rare association of synovial chondromatosis involving the shoulder in a rheumatoid arthritis patient. The symptoms have improved with anti-tumor necrosis factor drugs. Consequently, there was no need for invasive therapy to treat synovial chondromatosis. CONCLUSION: Synovial chondromatosis can be aggressive and destructive. More trials are needed to establish a better clinical diagnostic strategy and pharmacological management.


Assuntos
Artrite Reumatoide , Condromatose Sinovial , Articulação do Ombro , Humanos , Ombro/patologia , Condromatose Sinovial/diagnóstico por imagem , Condromatose Sinovial/patologia , Articulação do Ombro/diagnóstico por imagem , Membrana Sinovial , Artrite Reumatoide/complicações , Artrite Reumatoide/patologia
18.
Artigo em Inglês | MEDLINE | ID: mdl-36535888

RESUMO

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.


Assuntos
Condromatose Sinovial , Transtornos da Articulação Temporomandibular , Pessoa de Meia-Idade , Humanos , Feminino , Condromatose Sinovial/diagnóstico por imagem , Condromatose Sinovial/cirurgia , Condromatose Sinovial/patologia , Tomografia Computadorizada por Raios X , Articulação Temporomandibular/patologia , Transtornos da Articulação Temporomandibular/diagnóstico por imagem , Transtornos da Articulação Temporomandibular/cirurgia , Transtornos da Articulação Temporomandibular/patologia , Membrana Sinovial , Imageamento por Ressonância Magnética
20.
BMC Oral Health ; 22(1): 662, 2022 12 31.
Artigo em Inglês | MEDLINE | ID: mdl-36587200

RESUMO

BACKGROUND: The coexistence of calcium pyrophosphate dihydrate crystal deposition (CPP) and synovial chondromatosis (SC) in the temporomandibular joint (TMJ) is rarely reported. CPP disease (CPPD) is complex arthritis synonymous with excessive pyrophosphate production and variable aberrations in mineral and organic phase metabolism of the joint cartilage, leading to local inundated CPP and crystal deposition of partially deciphered predispositions. Meanwhile, SC is a rare benign synovial joint proliferative disease of unclear etiology and has a low risk of malignant transformation. However, SC manifests severe joint disability and dysfunction because of connective tissue metaplasia of the synovial membrane, which forms cartilaginous nodules with or without calcifications or ossifications. These nodules often detach and form intra-articular loose bodies and very rarely within extraarticular spaces. CASE PRESENTATION: We report the case of a 61-year-old man to expand the body of literature on these unusual coexisting arthropathies of the TMJ. The patient presented to our hospital in 2020 with complaints of pain in the right TMJ and trismus for over 6 months. Radiographic assessments of the TMJ provided a preoperative provisional diagnosis of SC. However, the histopathology of the open biopsy revealed tumor-like lesions comprising several deposits of rhomboid and rod-shaped crystals that displayed positive birefringence in polarized light, confirming a coexistence of CPPD. A second-stage operation was performed for the complete removal of the loose bodies and chalk-like lesions including synovectomy. No evidence of recurrence was recorded after a follow-up of nearly 1.5 years. CONCLUSIONS: Isolated CPPD and SC of the TMJ are prevalent in the literature however, monoarticular coexistence of these diseases is rare, due to the lack of consistency in the diagnostic criteria in clinical practice. Moreover, optimal treatment depends on several considerations. This report delineated the molecular etiopathology and underscored the need for continued deciphering of the causal mechanisms of coexisting CPPD and SC of the TMJ. In addition, the importance of confirmatory testing for accurate diagnosis, and appropriate management of these diseases were discussed.


Assuntos
Condrocalcinose , Condromatose Sinovial , Transtornos da Articulação Temporomandibular , Masculino , Humanos , Pessoa de Meia-Idade , Condromatose Sinovial/complicações , Condromatose Sinovial/diagnóstico por imagem , Condromatose Sinovial/cirurgia , Pirofosfato de Cálcio , Transtornos da Articulação Temporomandibular/complicações , Articulação Temporomandibular , Condrocalcinose/diagnóstico , Condrocalcinose/diagnóstico por imagem
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