TMJ Synovial Chondromatosis with Intracranial Extension: Systematic Review

Objective:

Synovial Chondromatosis is a rare benign arthropathy of unknown etiology that usually affects a single joint and is characterized by the formation of highly cellular, metaplastic cartilaginous foci. The objective of this study was to determine the frequency of occurrence of TMJ Synovial Chondromatosis with intracranial extension and determine the frequency of accompanying signs and symptoms. The prevalence of radiographic findings known as “loose bodies or joint mice” in this group of patients was also evaluated.

Methods:

A literature search was performed using the medical databases Ovid Medline, PubMed, and Google Scholar from inception to December 2007. The keywords in the literature search were Synovial chondromatosis, intracranial chondromatosis, temporomandibular joint (TMJ) tumors, loose bodies and joint mice. Frequency and cumulative percentages were calculated for presenting symptoms, clinical and radiographic features, and sex.

Results:

Fourteen cases of Synovial Chondromatosis with intracranial extension were identified. The cases were reported between 1987 and 2007. Of the reported cases, 60% of the patients were female and 30% were male (2:1 ratio). All of the occurrences were unilateral. The most common presenting symptoms included pain in the affected TMJ, trismus, headache, facial swelling, open bite and facial paralysis. The prevalence of each of the common presenting symptoms was approximately 7%. The frequencies of presentation of facial swelling and open bite were twice as that of any other symptom within this group. The prevalence of radiographic loose bodies in this group was 57.1%.

Conclusions:

Synovial Chondromatosis with extension to the middle cranial fossae may present with a variety of clinical and radiographic signs and symptoms. The prevalence in females is higher than in males. A large majority of these cases have radiographic loose bodies or joint mice. Although the lesions extended intracranially, none of the reported cases had any associated mortality. Treatment was surgical universally.