[Chondromatose of the temporomandibular joint: Multicentric study and clarification from 14 cases]. / Chondromatose de l'articulation temporomandibulaire : étude multicentrique et mise au point à partir de 14 cas.

INTRODUCTION: The aim of our study was to analyse a series of patients suffering from temporomandibular joint (TMJ) chondromatosis treated in 2 departments of stomatology and maxillofacial surgery (University hospitals of the Conception in Marseille and of Caen) and to make a general review of this disease. MATERIAL AND METHODS: We conducted a retrospective study including all the patients treated for a TMJ chondromatosis in one of these 2 departments. Following parameters were analyzed: sex, ages at discovery and at surgery, symptoms, side, imaging, histology, recurrence and any other events considered as relevant. RESULTS: Fourteen patients could be included: 85.7 % were women. Average age at diagnosis was 40.14 (σ = 13.82; IC95: 32.90-47.38) (41 for women [σ = 14.74; IC95: 33.28-48.72] and 35 years for men [σ = 5.66, IC95: 27.16-42.84]). Average age at surgery was 40.86 (σ = 14.18; IC95: 33.43-48.28). There was no predominance of side; 57.14 % of the patients had a joint syndrome, 57.14 % a tumor syndrome, 28.57 % had pain and 14.29 % had headaches. Panoramic X-ray was informative in 3 cases only. CT scan showed intra-articular calcifications in half of the cases only but arthrosic modifications in all the cases. Magnetic resonance imaging (MRI) constantly showed intra-articular cartilage fragments. When histology was performed, it found the synovial to be normal in one case and multiple nodules with clear cartilaginous differentiation in another case. One patient suffered from a second contralateral localization 10 years later. DISCUSSION: Chondromatosis has a slow evolution and is asymptomatic for a long time. MRI allows to evoke the diagnosis and to locate precisely the osteochondromas. Diagnosis is confirmed by histology that highlights a synovial metaplasia and more or less calcified chondromas. The main differential diagnosis to be eliminated because of prognostic reasons is the synovial chondrosarcoma. Treatment consists in surgical removing of the chondromas. Evolution is usually favorable.

Clinical and Imaging Findings of Temporomandibular Joint Synovial Chondromatosis: An Analysis of 10 Cases and Literature Review.

PURPOSE: This study investigated clinical and imaging features of synovial chondromatosis (SC) of the temporomandibular joint (TMJ) for use in clinical applications. MATERIALS AND METHODS: We analyzed clinical data from 10 patients with SC of the TMJ in our hospital from 2011 to 2015. We also reviewed and analyzed relevant literature included in the National Center for Biotechnology Information database in the past decade using the search terms "synovial chondromatosis" and "temporomandibular joint." RESULTS: The incidence of SC of the TMJ was higher in female patients than in male patients (male-to-female ratio, 1:2.22). It occurred most often in middle age (mean, 47.2 years). The characteristic symptoms of SC in the TMJ were pain (90.8%), swelling (67.1%), limited ability to open the mouth (68.4%), deviant jaw opening (34.2%), and crepitation (31.6%). Computed tomography (CT) (42.9%) and magnetic resonance imaging (45.4%) were the most common techniques used to assess SC in the TMJ, and cone-beam CT (10.9%) also was used to make preliminary diagnoses based on its imaging findings. Open surgery was the preferred treatment of SC of the TMJ, and the recurrence rate was low. CONCLUSIONS: The main clinical characteristics of SC of the TMJ are pain, swelling, limited mouth opening, joint sounds, and deviant jaw opening. Imaging features include abnormal high-density shadows, condyle hyperostosis or destruction, changes in the temporal bone, and widening of the joint space. Cone-beam CT is useful for diagnosis of SC of the TMJ.

[Temporomandibular joint primitive tumors and pseudo tumors]. / Pseudotumeurs et tumeurs primitives de l'articulation temporomandibulaire.

The temporomandibular joint (TMJ) can be the site of bone, cartilaginous, or synovial tumors. There is no well-defined histological classification. We listed all benign tumors, malignant primitive tumors, and rare pseudo tumors of the TMJ. We provide a list to help for the diagnosis and the differential diagnosis of non-tumoral lesions by far the most frequent.

Extraarticular synovial chondromatosis: review of epidemiology, imaging studies, microscopy and pathogenesis, with a report of an additional case in a child.

A rare benign condition of uncertain etiology and pathogenesis, Synovial Chondromatosis (SC) is most often seen intraarticularly in adults but only a handful of cases have been reported extraarticularly in children. Symptoms and physical signs consist of pain, swelling, and osteoarthritic changes related to a mass effect. Here we discuss the case of a 9-year-old boy with documented SC of the knee and critically review the Epidemiology, Clinical Presentation, Gross Anatomy and Microscopic Histopathologic Features as well as the role of Imaging Studies in Diagnosis. In addition, this paper reviews Current Pathogenetic Concepts including the infrequent but distinct possibility of malignant transformation.

Condromatosis sinovial de la ATM / Synovial chondromatosis of the TMJ

La condromatosis sinovial es una rara enfermedad articular cuya baja prevalencia es aún más marcada en la ATM. El diagnóstico clínico e imagenológico no es sencillo porque es fácilmente confundible con trastornos temporomandibulares por su semiología y porque la radiología no aporta datos de interés; sólo las TAC y las RMI son útiles. Como si esto fuera poco, también deben tenerse en cuenta algunas neoplasias o artropatías de otro origen que pueden confundirnos. El tratamiento es quirúrgico, si el caso lo requiere. (AU)

Generalized synovial chondromatosis of the knee: a comparison of removal of the loose bodies alone with arthroscopic synovectomy.

Thirteen patients with generalized synovial chondromatosis of the knee were treated by either removal of the loose bodies alone (n = 5) or arthroscopic synovectomy (n = 8). The average follow-up was 38 months (range 23-61). There were three recurrences in the loose body removal group, which were subsequently treated by arthroscopic synovectomy. Statistical analysis of the results shows a significant improvement in pain, synovitis and effusion, range of movement, and function after either treatment. The group treated by arthroscopic synovectomy had significantly lower recurrence rates (p = 0.02). We recommend arthroscopic synovectomy for patients with generalized synovial chondromatosis. However, if loose bodies alone are removed, a recurrence can be successfully treated by an arthroscopic synovectomy.