Case Report

Tophaceous Calcium Pyrophosphate Dihydrate Deposition Disease of the Temporomandibular Joint

JENNIFER L. REYNOLDS, IAN R. MATTHEW, and ANDREW CHALMERS

ABSTRACT.

Tophaceous pseudogout is a rare manifestation of calcium pyrophosphate dihydrate (CPPD) deposition disease that particularly affects the temporomandibular joint (TMJ). We describe a case of tophaceous pseudogout and review the literature. Thirty-four cases of chronic CPPD deposition disease affecting the TMJ are described. Symptoms usually included pain and swelling. Most patients required surgery because of extensive crystal deposits, usually localized to the joint and adjacent structures but occasionally invasive. For many patients, malignancy was the preoperative diagnosis. Although patients with acute pseudogout of the TMJ may have involvement of other joints, tophaceous pseudogout was predominantly isolated to the TMJ. (J Rheumatol 2008;35:717-21)

Key Indexing Terms:

PSEUDOGOUT
CALCIUM PYROPHOSPHATE DIHYDRATE DEPOSITION
CHONDROCALCINOSIS
TEMPOROMANDIBULAR JOINT

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From the Division of Rheumatology and Division of Oral and Maxillofacial Surgery, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.

J.L. Reynolds, MD, Rheumatology Fellow; A. Chalmers, MD, FRCPC (Rheum), Professor, Division of Rheumatology; I.R. Matthew, PhD, MDentSc, BDS, FDSRCS(Eng & Ed), Assistant Professor, Chair, Division of Oral and Maxillofacial Surgery, University of British Columbia.

Address reprint requests to Dr. A. Chalmers, Mary Pack Arthritis Centre, 895 West 10th Ave., Vancouver, BC V5Z 1L7. E-mail: achalmers@arthritisresearch.ca

Accepted for publication November 6, 2007.

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