伴关节盘穿孔的颞下颌关节滑膜软骨瘤1例报告及文献复习

目的：分析伴关节盘穿孔的颞下颌关节滑膜软骨瘤（TMJSC）患者的临床表现、发病机制、辅助检查、鉴别诊断和治疗方法，为TMJSC患者的诊疗提供依据。方法：收集1例TMJSC患者的临床资料，并分析诊治过程，并进行相关文献复习。结果：患者，女性，53岁，因发现右侧颞下颌关节（TMJ）偶有压痛1年余入院。计算机断层摄影（CT）检查显示上颌窦壁及关节周围改变，磁共振成像（MRI）可见关节腔弥漫性结节状低、等异常信号，关节腔液体信号影增多，关节间隙增宽。对患者采取开放性手术治疗，切除游离体和病变滑膜，手术顺利完成，术后组织病理学检查结果为滑膜软骨瘤（SC）。随访6个月未见复发。结论：TMJSC诊断应采用组织病理学检测结合CT和MRI辅助检查，手术治疗是有效的治疗手段，病理诊断为诊断TMJSC的金标准。

Synovial chondromatosis of temporomandibular joint with disc perforation: A case report and literature review

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.