Synoival Chondromatosis at Temporomandibular Joint-A Case Report and Literature Review

顳顎關節之滑液囊軟骨瘤病－病例報告與文獻回顧

張家豪(Chia-Hao Chang) ； 劉崇基(Chung-Ji Liu)

《臺灣口腔顎面外科學會雜誌》 30卷2期 (2019/06) Pp. 125-133

摘要

Synovial chondromatosis (SC) is a benign nodular cartilaginous proliferation that mainly occurs in large joints but rarely seen in temporomandibular joints (TMJs). Patients with this disease usually present with nonspecific symptoms and signs similar with other temporomandibular joint disorders (TMDs) including swelling, pain, crepitus joint sounds, deviant jaw opening, and limitation of jaw movement, therefore the diagnosis is made by radiographic examination. The etiology of SC remains unclear. Main characteristic of SC is the formation of cartilaginous nodules that may be pedunculated and/or detach from the synovial membrane, becoming loose bodies within the joint space. Surgery is the therapeutic choice to remove nodules and loose bodies from the joint space. In this case report, we present a case of a 29-year-old female first diagnosed myofascial pain dysfunction (MPD) but then diagnosed SC at left TMJ by the MRI and received surgery. The final pathological report proved as SC. We would also review the epidemiology, radiographic features, and the choices of surgical intervention of SC.

關鍵字

Synovial chondromatosis ； Temporomandibular joint

並列摘要

滑液囊軟骨瘤病是一種良性節結狀軟骨增生，好發在大關節但少見於顳顎關節。患有此疾病患者，通常呈現與其他顳顎關節疾患相似的非特異性症狀與體徵，包含腫脹、疼痛、關節捻髮聲、下顎張口偏斜與下顎活動度受限，因此診斷上通常需藉由放射線檢查。滑液囊軟骨瘤病目前病因仍未明，主要徵象為在關節腔中，滑液囊生成軟骨性結狀體接著突出或脫離滑液囊並形成游離體。手術為治療方式，透過手術移除關節腔之結狀體與游離體。本病例報告中，呈現一名29歲女性患者一開始被診斷為肌筋膜疼痛症候群，接著透過核磁共振檢查診斷為左側顳顎關節滑液囊軟骨瘤病並接受手術，最終病理報告確診為滑液囊軟骨瘤病。本病例報告中也將回顧滑液囊軟骨瘤病之流行病學、放射學之特色與手術介入術式之選擇。

並列關鍵字

滑液囊軟骨瘤病 ； 顳顎關節