Severe Pain and Limited Mouth Opening Due to TMJ Chondromatosis: a Case Report

Synovial chondromatosis (SC) is a benign and rare condition described as a synovial tissue metaplasia. TMJ is affected in only 3% of all related cases, with upper compartment largely affected. The aim of this paper is report a SC case and the use of arthroscopy as an auxiliary diagnostic method. This article presents a 31-year-old woman referring pain on right TMJ, associated with limitation of mouth opening. Arthrocentesis was performed but resulted unsuccessfully in symptom reduction. After detection of atypical images in right TMJ, by magnetic resonance image, arthroscopy was executed, allowing a direct and clear visualization of cartilaginous loose bodies in upper compartment. Open surgery and complete removal of affected tissue were realized. No tenderness and clicking in the right TMJ was observed in further follow-up. Maximal interincisal opening was 43 mm, and she had normal occlusion. There were no complications. Open surgery of TMJ is seen to be the most effective treatment for SC. Arthroscopy, as a diagnostic method, seems to be an important auxiliary tool, raising accuracy of alterations in TMJ.