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滑膜软骨瘤病原发于颞下颌关节下腔:一例病例报告及文献复习。

Synovial chondromatosis originally arising in the lower compartment of temporomandibular joint: a case report and literature review.

机构信息

Department of Oral & Maxillofacial Surgery, Ninth People's Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai Key Laboratory of Stomatology, No. 639 Zhi-zao-ju Road, Shanghai 200011, PR China.

出版信息

J Craniomaxillofac Surg. 2011 Sep;39(6):459-62. doi: 10.1016/j.jcms.2010.10.012. Epub 2010 Nov 20.

Abstract

INTRODUCTION

More than 200 cases of synovial chondromatosis (SC) in the TMJ were reported. Most of SC described exclusively involved the upper compartment of the joint. SC originally arising in the lower compartment is rarely found.

MATERIAL AND METHODS

This article presents a 50-year-old man with a slow growing, pain, preauricular swelling in left side and the limitation of mouth-opening. Panoramic radiograph, CT scans and MR images were taken. An arthroscopic examination and a surgical intervention were performed.

RESULTS

Panoramic radiograph and CT scans didn't reveal the calcifying lesions in left TMJ region. Sagittal MR images and the arthroscopic examination demonstrated distinct nodules within an extremely expanded lower joint compartment and a normal position of the articular disc. All loose bodies and grossly abnormal synovium were removed. The diagnosis of SC was confirmed by histologic examination.

CONCLUSION

MRI and arthroscopy may be helpful diagnostically. Removal of all involved synovium, and loose cartilaginous bodies may be required for adequate treatment.

摘要

简介

已有超过 200 例颞下颌关节滑膜软骨瘤病(SC)的病例报道。大多数 SC 仅累及关节的上腔。最初发生在下腔的 SC 很少见。

材料与方法

本文介绍了一位 50 岁男性,其左侧出现缓慢生长的疼痛、耳前肿胀和张口受限。拍摄了全景片、CT 扫描和 MRI 图像。进行了关节镜检查和手术干预。

结果

全景片和 CT 扫描未显示左侧 TMJ 区域的钙化病变。矢状位 MRI 图像和关节镜检查显示在下关节腔极度扩张的部位有明显的结节和关节盘的正常位置。所有游离体和明显异常的滑膜均被切除。组织学检查证实了 SC 的诊断。

结论

MRI 和关节镜检查可能具有诊断价值。为了获得充分的治疗效果,可能需要切除所有受累的滑膜和游离软骨体。

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