顎関節に生じた Synovial osteochondromatosis の1例ならびに文献的考察

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Synovial osteochondromatosis is a disease of cartilagenous metaplasia of synovial membrane accompanied with loose bodies within the articular cavity. It occurs most often in the knee and is also seen fairly often in the elbow and the hip, however involvement of the temporomandibular joint (TMJ) is very rare.<BR>A 36-year-old woman visited our clinic with a pain in the right TMJ region. After an accidental blow to the chin seven years earlier, she had acquired a crepitus in the right TMJ. On examination, there was slight right preauricular swelling and tenderness. Panoramic radiograph, arthrography, CT scan and arthroscopy revealed calcified loose bodies in the superior articular cavity.<BR>Removal of all loose bodies, synovectomy, discectomy and condylectomy were performed. The loose bodies were 22 white nodules 3 to 6mm in diameter. Histological examination of the loose bodies demonstrated cartilagenous metaplasia.<BR>27 months after surgery there had been no recurrence of the symptoms.<BR>We reviewed 39 cases of the TMJ reported in the literature, and found that trauma may play an etiological role and synoviectomy and condylectomy may be necessary in some cases.
社団法人日本口腔外科学会の論文