A case of deposition of calcium pyrophosphate dehydrate crystals with synovial chondromatosis in the temporomandibular joint

Nashi, Masanori; Yamamoto, Shinsuke; Maeda, Keigo; Taniike, Naoki; Hara, Shigeo; Takenobu, Toshihiko

doi:10.1016/j.ajoms.2021.06.007

Cited by 2 publications

(2 citation statements)

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“…In contrast, although SC of the TMJ was previously considered a rare condition, the recent technological advancement in radiology dramatically minimized the diagnostic challenges and improved publication [ 22 ]. However, the coexistence of both CPPD and SC in the TMJ remains a rare condition [ 48 ].…”

Section: Discussionmentioning

confidence: 99%

Management of temporomandibular joint diseases: a rare case report of coexisting calcium pyrophosphate crystal deposition and synovial chondromatosis

Murahashi

Ntege

Higa³

et al. 2022

BMC Oral Health

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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.

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Section: Discussionmentioning

confidence: 99%

Management of temporomandibular joint diseases: a rare case report of coexisting calcium pyrophosphate crystal deposition and synovial chondromatosis

Murahashi

Ntege

Higa³

et al. 2022

BMC Oral Health

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“…The deposition of calcium pyrophosphate dihydrate (CPPD) crystals in synovial fluid or tissues causes arthritis or ''pseudogout''. These crystal deposits can cause significant morbidity and are often underdiagnosed [1][2][3][4][5][6]. The disease is idiopathic in most patients; however, it has been associated with aging, osteoarthritis, gout, hyperparathyroidism, and metabolic disorders such as hemochromatosis and hypomagnesemia [7][8][9][10].…”

Section: Introductionmentioning

confidence: 99%

Influence of Glycyl‐L‐Glutamic Acid Dipeptide on Calcium Pyrophosphate Dihydrate Crystallization

Polat

Eral

2023

Chem Eng & Technol

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The increasing prevalence of calcium pyrophosphate dihydrate (CPPD) deposition disease, a form of arthritis with high inflammatory potential, has triggered considerable interest in the search for additives to prevent CPPD crystal formation, particularly in the field of biomineralization. In this context, CPPD crystallization in aqueous solution with and without glycine, glutamic acid, or glycyl‐L‐glutamic acid as crystal‐growth modifier was experimentally investigated. The produced crystals were characterized structurally, morphologically, and in terms of their surface charge. In addition, the thermal degradation profiles of CPPD crystals obtained with and without the modifiers were characterized by TGA‐FTIR, and the major volatile product was H2O.

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A case of deposition of calcium pyrophosphate dehydrate crystals with synovial chondromatosis in the temporomandibular joint

Cited by 2 publications

References 22 publications

Management of temporomandibular joint diseases: a rare case report of coexisting calcium pyrophosphate crystal deposition and synovial chondromatosis

Management of temporomandibular joint diseases: a rare case report of coexisting calcium pyrophosphate crystal deposition and synovial chondromatosis

Influence of Glycyl‐L‐Glutamic Acid Dipeptide on Calcium Pyrophosphate Dihydrate Crystallization

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