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Interventional radiology of synovial chondromatosis in the temporomandibular joint using a thin arthroscope

¹ Department of Oral and Maxillofacial Radiology, Nihon University School of Dentistry, Tokyo, Japan, ² First Department of Oral and Maxillofacial Surgery, School of Dental Medicine, Tsurumi University, Yokohama, Japan, ³ Removable Partial Denture Prosthodontics, Nihon University School of Dentistry, Tokyo, Japan, ⁴ Temporomandibular Joint Clinic, Faculty of Dentistry, Tokyo Medical and Dental University, Tokyo, Japan

*Correspondence to: Kazuya Honda, DDS, PHD, Department of Oral and Maxillofacial Radiology, Nihon University School of Dentistry, 1-8-13 Kanda Surugadai Chiyoda-ku Tokyo, 101-8310 Japan. E-mail: honda-k{at}dent.nihon-u.ac.jp

Received 4 March 2007; revised 4 June 2007; accepted 5 June 2007

This case report describes, for the first time, the use of interventional radiology following arthroscopy with a thin arthroscope for the diagnosis and treatment of synovial chondromatosis (SC) of the temporomandibular joint (TMJ). Therapeutic joint irrigation concomitant with arthroscopic observation of the superior joint compartment (SJC) was performed in a patient with functional TMJ pain caused by SC. The thin arthroscope was inserted with the aid of an X-ray fluoroscope. Arthroscopy confirmed that the SC was at disease stage II and that synovitis existed throughout the SJC. The initial maximal interincisor opening (MIO) was 30 mm, while after the joint-irrigation procedure the MIO was 40 mm. In addition, the TMJ pain was greatly reduced after joint irrigation. Our findings demonstrate that interventional radiology with a thin arthroscope is clinically useful for the diagnosis and primary treatment of patients with painful SC in the TMJ.

Keywords: interventional radiology; joint irrigation; synovial chondromatosis; temporomandibular joint