Romero N, Mulcahy CF, Barak S, Shand MF, Badger CD, Joshi AS. Synovial osteochondromatosis of the temporomandibular joint: A case report. World J Otorhinolaryngol 2019; 8(2): 12-18 [DOI: 10.5319/wjo.v8.i2.12]
Corresponding Author of This Article
Collin F Mulcahy, MD, Resident Physician, Department of Surgery, Division of Otolaryngology, Head and Neck Surgery, George Washington University Hospital, 2300 M Street NW, Washington, DC 20037, United States. cfmulcahy@gwu.edu
Research Domain of This Article
Otorhinolaryngology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Otorhinolaryngol. Dec 20, 2019; 8(2): 12-18 Published online Dec 20, 2019. doi: 10.5319/wjo.v8.i2.12
Synovial osteochondromatosis of the temporomandibular joint: A case report
Nahir Romero, Collin F Mulcahy, Stephanie Barak, Muhammed F Shand, Christopher D Badger, Arjun S Joshi
Nahir Romero, Collin F Mulcahy, Christopher D Badger, Arjun S Joshi, Department of Surgery, Division of Otolaryngology, Head and Neck Surgery, George Washington University Hospital, Washington, DC 20037, United States
Stephanie Barak, Department of Pathology, George Washington University Hospital, Washington, DC 20037, United States
Muhammed F Shand, George Washington University School of Medicine and Health Sciences, Washington, DC 20037, United States
Author contributions: Romero N drafted the initial manuscript, reviewed and revised the manuscript and participated in the ancillary care of the patient as a clinical assistant; Mulcahy CF reviewed the and contributed to the manuscript; Barak S was the patient’s clinical pathologist and as such analyzed and interpreted the pathologic process of the disease and reviewed the manuscript; Shand MF reviewed, revised and formatted the manuscript; Badger CD contributed to, reviewed, and revised the manuscript; Joshi AS was the patient’s head and neck surgeon who developed the treatment plan, cared for the patient in the follow up period, reviewed and revised the manuscript; All authors approved the final manuscript for submission.
Informed consent statement: Informed written consent was obtained from the patient for display of case-related images for research purposes. This case contains no identifiable patient characteristics.
Conflict-of-interest statement: The authors declare they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Collin F Mulcahy, MD, Resident Physician, Department of Surgery, Division of Otolaryngology, Head and Neck Surgery, George Washington University Hospital, 2300 M Street NW, Washington, DC 20037, United States. cfmulcahy@gwu.edu
Telephone: +1-202-7413250 Fax: +1-202-7413382
Received: June 20, 2019 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 Processing time: 188 Days and 4.2 Hours
Abstract
BACKGROUND
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.
CASE SUMMARY
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.
CONCLUSION
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.
