Synovial chondromatosis of temporomandibular joint with disc perforation: A case report and literature review / 吉林大学学报(医学版)

Objective: To analyze the clinical manifestations, pathogenesis, auxiliary examinations, differential diagnosis and treatment methods of the patient with synovial chondromatosis of temporomandibular joint (TMJSC) with disc perforation, and to provide the basis for the diagnosis and treatment of TMJSC∗ patients. Methods: The clinical data of one patient with TMJSC∗ were collected, and the diagnosis and treatment process was analyzed, and the related literatures were reviewed. Results: The female 53-year-old patient was admitted to hospital due to occasional tenderness in the right TMJ for more than 1 year. The computerized tomography (CT) results revealed that the changes could be found around the wall of maxillary sinus and the joint. The magnetic resonance imaging (MRI) results showed the diffused nodular, low and equal signals in the joint cavity, the shadow of fluid signals in the joint cavity was increased, and the joint space was broadened. The open surgery was performed in the patient successfully, including the removal of loose bodies and synovectomy, and the pathology result after opration was synovial chondromatosis (SC). No recurrence was found during 6 months after follow-up. Conclusion: The histopathology examination assisted with CT and MRI should be perfomed in the diagnosis of TMJSC. Surgical treatment is an effective method, and the pathological diagnosis is the gold standard for TMJSC.

Remaining Loose Bodies after Arthroscopic Surgery Including Extensive Capsulectomy for Synovial Chondromatosis of the Hip

BACKGROUND: The purpose of our study was to evaluate the usefulness of hip arthroscopy including extensive capsulectomy for synovial chondromatosis of the hip. METHODS: From 2008 to 2016, 13 patients with synovial chondromatosis of the hip were treated with arthroscopic removal of loose bodies and synovectomy using three arthroscopic portals. An extensive capsulectomy was performed to allow the remaining loose bodies to be out of the extracapsular space, and the excised capsule was not repaired. All patients were assessed by clinical scores and the radiographs were reviewed to determine whether the remaining loose bodies disappeared at the last follow-up. RESULTS: Eight men and two women were followed up for a minimum of 1 year (mean, 3.8 years; range, 1 to 6.8 years) after hip arthroscopy. Clinical outcomes such as modified Harris hip score, University of California Los Angeles score, and Western Ontario and McMaster Universities Osteoarthritis Index score improved at the last follow-up. Although seven hips had remaining loose bodies after arthroscopic surgery, the remaining loose bodies disappeared in five hips (71.4%) at the last follow-up. CONCLUSIONS: Arthroscopic surgery was useful to treat synovial chondromatosis of the hip. In spite of limited removal of loose bodies, arthroscopic procedures including extensive capsulectomy could be effective for the treatment of synovial chondromatosis of the hip.

A Pleural Loose Body Mimicking a Pleural Tumor: A Case Report

We present a rare case of a pleural loose body, thought to be a pedunculated pleural tumor, found incidentally in a 58-year-old female. Computed tomography showed a non-enhancing mass, which migrated along the mediastinum and paravertebral area. Thoracoscopic surgery revealed a 4 cm, soap-like mass that was found to be a fibrin body consisting of hyalinized collagen histopathologically. Mobility and the lack of contrast enhancement of a pleural mass are important clues to diagnosing this benign condition.

A Giant Peritoneal Loose Body

Peritoneal loose bodies (PLBs) are usually discovered incidentally during laparotomy or autopsy. A few cases of giant PLBs presenting with various symptoms have been reported in the literature. Here, we describe a case of a giant PLB incidentally found in the pelvic cavity of a 50-year-old man. Computed tomography revealed a free ovoid mass in the pelvic cavity that consisted of central dense, heterogeneous calcifications and peripheral soft tissue. The mass was an egg-shaped, hard, glistening concretion measuring 7.5x7.0x6.8 cm and weighing 160 g. This concretion consisted of central necrotic fatty tissue surrounded by concentrically laminated, acellular, fibrous material. Small PLBs usually do not require any specific treatment. However, if PLBs cause alimentary or urinary symptoms due to their large size, surgical removal may be recommended. It is essential for clinicians to be aware of this entity and its characteristic features to establish the correct diagnosis.

Giant Peritoneal Loose Body in the Pelvic Cavity

We report a case of a large peritoneal loose body diagnosed on computed tomography. The most common causes of a peritoneal loose body are thought to be torsion and separation of the appendices epiploicae. Peritoneal loose bodies are usually small, 0.5 to 2.5 cm in diameter. However, "giant" peritoneal loose bodies, larger than 4 cm in diameter, are an uncommon disease and present with various symptoms, and are difficult to diagnose preoperatively. Especially, abdominal large peritoneal loose bodies are frequently misdiagnosed as tumorous disease preoperatively. In our case, the loose body appeared as a round pelvic mass with central calcifications and a distinct fat plane separating it from adjacent organs. Preoperatively, we suspected a tumorous lesion from the wall of the upper rectum; however, at laparoscopy, a large peritoneal loose body was detected. An extraction of the giant peritoneal loose body was performed laparoscopically.

Articular loose body, Synovial Chondromatosis of the Temporomandibular Joint: a Case Report

Synovial chondromatosis is an uncommon disease of cartilage transformation of synovial membrane with formation of loose bodies within the joint space. The involvement of temporomandibular joint is very rare. Symtoms include swelling, pain, stiffness of the jaw, and inability to close the jaw. A case involving the temporomandibular joint(TMJ) and non-symptoms is presented.

Articular loose body, Synovial Chondromatosis of the Temporomandibular Joint: a Case Report

Synovial chondromatosis is an uncommon disease of cartilage transformation of synovial membrane with formation of loose bodies within the joint space. The involvement of temporomandibular joint is very rare. Symtoms include swelling, pain, stiffness of the jaw, and inability to close the jaw. A case involving the temporomandibular joint(TMJ) and non-symptoms is presented.

A Case of Peritoneal Loose Body in a Child / 대한소아소화기영양학회지

A peritoneal loose body is reported to develop because of torsion and separation of the epiploic appendages. The condition is usually symptomless and may be incidentally during abdominal surgery or autopsy. It usually occurs in middle-aged and elderly adults and is very rare in children. In this paper, we report a case of a peritoneal loose body in the pelvic cavity of a 10-year old-girl who presented with urinary frequency and left lower abdominal discomfort. A second plain X-ray film of the abdomen, obtained before surgery, in a different view than the first, revealed that the calcified mass had migrated to a lower position. The mass was laparoscopically resected, and histological examination revealed it to be a fibrotic nodule with central liquefaction and calcification.

Intra-articular Avulsion Fractures of the Malleolus in Chronic Ankle Pain / 대한족부족관절학회지

PURPOSE: We report our results of arthroscopic treatment of symptomatic avulsion fracture of the malleolus in chronic ankle pain, and also analyzed the clinical and radiological features for evaluating the good candidate for arthroscopic treatment. MATERIALS AND METHODS: Fourteen patients who were diagnosed with intra-articular avulsion fractures of the malleolus received arthroscopic surgery and were followed up for at least a year. The clinical and radiological characters including MRI and arthroscopic findings were reviewed. Clinical assessments were done according to the AOFAS score system. RESULTS: There was a history of inversion type of the injury in most cases and local tenderness of lesion site was a unique. MRI study showed thickened anterior talofibular ligament (ATFL) in 8 cases (57%) and discontinued ATFL in 3 cases (21%). Enhanced signal surrounding soft tissue corresponding to synovial inflammation and impingement was found in 12 cases (86%). Preoperative score of all patients were 74.0+/-5.5, which improved to 89.3+/-6.7 at the follow-up after the treatment (P<0.001). CONCLUSION: Most patients had history of injury and localized tenderness in the area coinciding with radiological findings. Thickened ATFL and contrast enhancement around the ossicle were frequently found. Symptomatic avulsion fractures of the malleolus associated with the clinical and radiological findings above could be a good candidate for arthroscopic treatment.

Intra-articular Avulsion Fractures of the Malleolus in Chronic Ankle Pain / 대한족부족관절학회지

PURPOSE: We report our results of arthroscopic treatment of symptomatic avulsion fracture of the malleolus in chronic ankle pain, and also analyzed the clinical and radiological features for evaluating the good candidate for arthroscopic treatment. MATERIALS AND METHODS: Fourteen patients who were diagnosed with intra-articular avulsion fractures of the malleolus received arthroscopic surgery and were followed up for at least a year. The clinical and radiological characters including MRI and arthroscopic findings were reviewed. Clinical assessments were done according to the AOFAS score system. RESULTS: There was a history of inversion type of the injury in most cases and local tenderness of lesion site was a unique. MRI study showed thickened anterior talofibular ligament (ATFL) in 8 cases (57%) and discontinued ATFL in 3 cases (21%). Enhanced signal surrounding soft tissue corresponding to synovial inflammation and impingement was found in 12 cases (86%). Preoperative score of all patients were 74.0+/-5.5, which improved to 89.3+/-6.7 at the follow-up after the treatment (P<0.001). CONCLUSION: Most patients had history of injury and localized tenderness in the area coinciding with radiological findings. Thickened ATFL and contrast enhancement around the ossicle were frequently found. Symptomatic avulsion fractures of the malleolus associated with the clinical and radiological findings above could be a good candidate for arthroscopic treatment.

Arthroscopic Treatment on the Osteochondritis Dissecans of the Adolescent Elbow / 대한정형외과학회잡지

PURPOSE: The purpose of this study was to evaluate the effect of arthroscopic management of osteochondritis dissecans(OD) of the elbow. MATERIALS AND METHODS: Seven patients rangeing from 13 to 20 years of age, and average age 15.7 years were evaluated in this study. All patients underwent arthroscopic removal of loose bodies followed by multiple drilling into the defect of the capitellum. The average follow-up period was 19.7 months (range, 16 to 28 months). Results were analyzed clinically using the elbow scoring system of Broberg and Morrey. RESULTS: There were five good and two excellent results. Three cases, however, showed slight medial instability while performing the valgus stress test. All patients had no or slight pain, and regained a full range of motion. Although four amateur athletes showed good results, they were unable to recover their pre-injury sports activity level. CONCLUSION: Arthroscopic removal of loose fragments for late stage OD enabled the evaluation of lesions of the anterior and posterior aspects of the joints, and minimized morbidity.

Synovial Chondromatosis of the Hip Joint / 대한정형외과학회잡지

PURPOSE: To evaluate the effectiveness of MRI in diagnostic studies and management of synovial chondromatosis involving the hip joint. MATERIALS AND METHODS: From November 1995 to September 1998, 6 patients from 6 cases of synovial chondromatosis involving the hip joint, underwent complete removal of loose bodies and subtotal excision of the synovial membrane. RESULTS: Preoperatively, all cases had hip pain and 5 cases had limited hip motion. Preoperative MRI revealed target-like lesion in T2 images and synovial hypertrophy. MRI findings revealed lesions in the inferomedial capsular portion in all cases and invading the intrapelvic portion in 2 cases. Pathologic findings revealed Milgram stage II in 5 cases and Milgram stage III in 1 case. It also showed 15 to 350 loose bodies in the diameter of 1 mm to 40 mm. Two cases received reoperations due to recurred lesions with pain 3 to 4 months after the operation. Average Harris Hip Score was 37.8 points preoperatively and 90.8 points in the last follow-up. CONCLUSION: For synovial chondromatosis involving the hip joint, MRI contributed to a faster and more accurate diagnosis and aided in surgical planning for complete removal. There was also a need for a radical synovectomy and loose body removal for prevention of recurrence.