Published online Dec 20, 2019. doi: 10.5319/wjo.v8.i2.12
Peer-review started: June 27, 2019
First decision: August 7, 2019
Revised: August 26, 2019
Accepted: November 26, 2019
Article in press: November 26, 2019
Published online: December 20, 2019
Synovial osteochondromatosis is a rare but benign condition that can result in significant impairment of joint functionality. This case report documents an uncommon presentation of this disorder occurring within the temporomandibular joint, causing the patient significant pain, trismus, and difficulty with daily activities such as eating and speaking. A review of the literature including disease mechanisms and previously documented cases is included to provide comprehensive background for clinical decision-making.
A 48-year-old male patient presented with a 3-mo history of trismus, crepitus with jaw movement and significant pain while chewing. Physical examination revealed a firm mass and tenderness to palpation at the right temporomandibular joint. Further workup revealed a bilobed mass extending into the joint space as well as significant bony erosion of the glenoid fossa. The patient underwent mass excision with joint reconstruction and pathology revealed synovial osteochondromatosis. The patient reported significant improvement in his symptoms postoperatively.
This report outlines the investigative approach and treatment course of synovial osteochondromatosis. The positive outcome following surgical intervention in this case emphasizes the importance of interdisciplinary collaboration and the potential for improvement in quality of life of this patient population.
Core tip: Synovial osteochondromatosis is a rare condition that arises from metaplasia and proliferation of synovial cells lining a joint space, which can impair joint function. It can be easily overlooked when working up non-specific symptoms such as preauricular pain and swelling. We present the case of a 48-year-old man with a history of significant unilateral temporomandibular joint (TMJ) pain, trismus, and dysphagia who was found to have synovial osteochondromatosis of the TMJ with erosion of the glenoid fossa. The patient underwent resection of the mass and TMJ reconstruction with a rib cartilage graft, resulting in alleviation of symptoms.