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Arthroscopic diagnosis and medical management of calcium pyrophosphate deposition disease in the temporomandibular joint
Institution:1. Thomas Jefferson University Hospital, Philadelphia, PA, USA;2. Herbert Wertheim College of Medicine – Florida International University, Miami, FL, USA;3. University of Alberta Faculty of Medicine and Dentistry, Edmonton, Alberta, Canada;4. Massachusetts General Hospital, Harvard School of Dental Medicine, Boston, MA, USA;1. Department of Maxillofacial Surgery, Erasmus MC – Sophia Children’s Hospital, University Medical Centre Rotterdam, Rotterdam, The Netherlands;2. Department of Obstetrics and Gynaecology, Division of Obstetrics and Prenatal Medicine, Erasmus MC – Sophia Children’s Hospital, University Medical Centre Rotterdam, Rotterdam, The Netherlands;3. Department of Clinical Genetics, Erasmus MC – Sophia Children’s Hospital, University Medical Centre Rotterdam, Rotterdam, The Netherlands;1. Department of Oral and Maxillofacial Surgery, the Affiliated Hospital of Qingdao University, Shandong Province, China;2. School of Stomatology, Qingdao University, Shandong Province, China;1. School of Dental Medicine and Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA;2. Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA;3. Department of Oral & Maxillofacial Surgery, University of Pennsylvania, Philadelphia, PA, USA;4. Department of Oral & Maxillofacial Surgery/Pharmacology, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA;5. School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA;6. Department of Oral and Maxillofacial Surgery, Philadelphia Veterans Affairs Medical Center, Penn Presbyterian Medical Center, University of Pennsylvania School of Dental Medicine, Philadelphia, PA, USA;1. Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Haidian District, Beijing, PR China;2. Department of Oral and Maxillofacial Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, PR China
Abstract:Calcium pyrophosphate deposition disease (CPPD) is a crystal arthropathy that can involve the temporomandibular joint. It is known to accelerate the osteoarthritic process, often initially presenting with advanced level of disease. The management of CPPD in the rheumatology and orthopedic literature is one of early diagnosis and medical management of acute attacks. The cases of three patients who presented with initial complaints of joint pain and limited mouth opening are presented. Preoperative imaging identified calcifications in two of these patients. Definitive diagnosis was achieved through arthroscopic-assisted biopsy. Rheumatology referrals revealed chondrocalcinosis of the knee in one patient. All patients had improved mouth opening and pain.
Keywords:TMJ arthroscopy  calcium pyrophosphate deposition disease  pseudogout
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