Advanced TMJ Synovial Chondromatosis with Chronic Disc Displacement: A Case Report and Surgical Perspective

Tofiq Bohra¹* and Saurabh Shah²

¹Consultant and Cleft Unit Head - S.L. Raheja Hospital - A Fortis Associate , Mumbai, India
²Certification in TMDs and Summer school, University of Vienna, USA

*Corresponding Author: Tofiq Bohra, Consultant and Cleft Unit Head - S.L. Raheja Hospital - A Fortis Associate , Mumbai, India.

Received: April 16, 2025; Published: April 26, 2025

Abstract

Background:: Synovial chondromatosis (SC) is a rare, benign condition characterised by cartilaginous metaplasia of the synovial membrane, leading to the formation of loose bodies within the joint. While commonly affecting large joints like the knee and hip, involvement of the temporomandibular joint (TMJ) is uncommon, accounting for less than 3% of cases.

Case Presentation: We report a case of a 45-year-old female presenting with a 3-year history of progressive left preauricular pain, swelling, and restricted mouth opening. Initial conservative treatments, including multiple arthrocentesis procedures, offered only temporary relief. MRI revealed joint effusion and degenerative changes in the condylar head, raising suspicion for synovial chondromatosis. Surgical intervention involved a left-sided open joint procedure for complete synovectomy, loose body removal, disc repositioning, and eminectomy. Histopathology confirmed the diagnosis. Simultaneously, arthroscopic disc repositioning and laser ablation were performed on the contralateral TMJ.

Discussion: This case underscores the importance of early imaging in chronic TMJ dysfunction. Delayed diagnosis can lead to advanced disease requiring open surgery.

Early detection and minimally invasive arthroscopy may offer effective management in earlier stages, especially in cases complicated by chronic disc displacement.

Conclusion: Timely diagnosis and tailored surgical intervention can optimize outcomes in TMJ-SC.

Keywords: Temporomandibular Joint; Synovial Chondromatosis; TMJ Disorders; Disc Displacement; Open Joint Surgery; Arthroscopy; MRI Diagnosis; Loose Bodies; TMJ Pain; Minimally Invasive Surgery

References

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Citation

Citation: Tofiq Bohra and Saurabh Shah. “Advanced TMJ Synovial Chondromatosis with Chronic Disc Displacement: A Case Report and Surgical Perspective".Acta Scientific Orthopaedics 8.5 (2025): 56-64.

Copyright

Copyright: © 2025 Tofiq Bohra and Saurabh Shah. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.