国际口腔医学杂志

国际口腔医学杂志 ›› 2021, Vol. 48 ›› Issue (6): 664-667.doi: 10.7518/gjkq.2021113

• 病例报告 • 上一篇    下一篇

焦磷酸钙沉积症继发颞下颌关节脱位1例

张哲1(),刘进2,王卫红1,3(),陈志强2,杨春3,刘丽3   

  1. 1.昆明医科大学附属口腔医院口腔颌面外科 昆明 650106
    2.新平县中医院骨科 玉溪 653400
    3.昆明医科大学附属口腔医院颞下颌关节病科 昆明 650106
  • 收稿日期:2021-03-10 修回日期:2021-08-27 出版日期:2021-11-01 发布日期:2021-10-28
  • 通讯作者: 王卫红
  • 作者简介:张哲,主治医师,硕士,Email： zhangzhe2200@163.com
  • 基金资助:
    云南省卫生健康委员会医学领军人才项目(L-201801)

Calcium pyrophosphate deposition disease complicated by temporomandibular joint dislocation

Zhang Zhe1(),Liu Jin2,Wang Weihong1,3(),Chen Zhiqiang2,Yang Chun3,Liu Li3   

  1. 1. Dept. of Oral and Maxillofacial Surgery, Affiliated Stomatological Hospital of Kunming Medical University, Kunming 650106, China
    2. Dept. of Orthopedics, Xinping County Hospital of Traditional Chinese Medicine, Yuxi 653400, China
    3. Dept. of Temporomandibular Joint Diseases, Affiliated Stomatological Hospital of Kunming Medical University, Kunming 650106, China
  • Received:2021-03-10 Revised:2021-08-27 Online:2021-11-01 Published:2021-10-28
  • Contact: Weihong Wang
  • Supported by:
    Medical Leading Talents Project of Yunnan Provincial Health Commission(L-201801)

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摘要：

发生于颞下颌关节（TMJ）部位的焦磷酸钙沉积症（CPPD）较为罕见。本文报道1例CPPD合并单侧TMJ多次脱位的54岁男性患者,先后误诊为习惯性TMJ脱位、滑膜软骨瘤和痛风。术后经组织病理学检查诊断为肿瘤性CPPD（假痛风）,因此对于长期自发性单侧TMJ脱位患者,不应除外CPPD,同时还要与TMJ滑膜软骨瘤和髁突骨软骨瘤相鉴别。

关键词: 焦磷酸钙沉积症, 颞下颌关节, 假痛风

Abstract:

Calcium pyrophosphate deposition disease (CPPD) occurred in the temporomandibular joint is relatively rare. This report describes a case of CPPD combined multiple dislocations of the unilateral temporomandibular joint (TMJ) in a 54-year-old male patient who was successively misdiagnosed as having habitual TMJ dislocation, synovial chondroma and gout. Unexpectedly, the postoperative histopathological diagnosis was neoplastic calcium pyrophosphate crystalline deposition disease (pseudogout). Therefore, TMJ calcium pyrophosphate deposition disease should not be excluded in patients with chronic spontaneous unilateral TMJ dislocation, and should also be distinguished from TMJ synovial chondromas and condylar osteochondromas.

Key words: calcium pyrophosphate deposition disease, temporomandibular joint, pseudogout

中图分类号: 

  • R782.6

图1

三维CT显示右侧TMJ脱位"

图2

术前影像学检查 A：三维CT显示TMJ已复位;B：增强CT显示右侧髁突头后侧散在多个斑点样钙化;C：MRI T1WI矢状面显示右侧TMJ区多个颗粒样低信号病灶。"

图3

术中发现肿瘤包膜完整且具有弹性"

图4

组织病理学检查,示肿瘤性CPPD,伴中性粒细胞和淋巴细胞浸润 HE × 20"

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