顎関節におけるピロリン酸カルシウム結晶沈着症の１例

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  • A case of calcium pyrophosphate dihydrate crystal deposition disease in the temporomandibular joint
  • ガク カンセツ ニ オケル ピロリンサン カルシウム ケッショウ チンチャクショウ ノ 1レイ

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Calcium pyrophosphate dihydrate (CPPD) deposition disease is one of the major types of crystalinduced arthritis associated with various pathological symptoms caused by deposition of CPPD in the surrounding tissues of joints. In major joints such as the knees, CPPD deposition disease has been often reported; however, the primary manifestation of CPPD deposition disease in the temporomandibular joint (TMJ) is relatively rare. We report a case of CPPD deposition disease in the left TMJ of a 72-year-old woman. She was referred to our department with a 2-month history of pain and swelling in the left preauricular region. CT and MRI images showed multiple calcified masses in the surrounding tissues in the left TMJ. Splint therapy during sleep was very effective in reducing jaw pain on movement. Because synovial chondromatosis of the left TMJ wassuspected, total extirpation of the calcified masses was performed via a preauricular approach. White, chalky soft masses were removed. Histological examination showed that the crystals were weakly birefringent under polarized light microscopy. A definitive diagnosis of CPPD deposition disease in the left TMJ was made. Six months after surgery, the clinical symptoms are very mild, with inter-incisal opening of 40mm.

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