Tophaceous pseudogout of the temporomandibular joint extending to the base of the skull

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Tophaceous pseudogout of the temporomandibular joint extending to the base of the skull

Gout is a painful condition and a form of arthritis caused due to the deposition of uric acid crystals (tophi) in the joints, mainly the toe.However, these deposits may occur anywhere in the body. When tophi accumulate on other soft tissues of the body and it is called as Tophaceous”.

Kudoh K et al presented a caseof tophaceous pseudogout (i.e., calcium pyrophosphate dihydrate (CPPD) crystal deposition disease) in the temporomandibular joint (TMJ), streching to the base of the skull. A 38-year-old man was shown to the hospital complaining of mild pain in the right chin and tip of the tongue. Radiographical screening reported a large calcified mass around the right TMJ, while imaging studies showed a large, granular, calcified mass surrounding the right condylar head and extending to the base of the skull. The mass was clinically and radiographically reckoned to be a pseudogout lesion. Diagnosis was confirmed through a biopsy using specimen collected under general anaesthesia.

The mass was thought to be composed of numerous rod-shaped and rhomboid crystals deposits, which suggested tophaceous pseudogout. Based on analysis by X-ray diffraction and Fourier transform infrared spectroscopy, the deposits were recognised as CPPD crystal deposition. These two crystallography methods were helpful in confirming the diagnosis of CPPD crystal deposition disease in the TMJ. 

Source:

Int J Oral Maxillofac Surg.

Link to the source:

https://www.ncbi.nlm.nih.gov/pubmed/27641810

Original title of article:

A case of tophaceous pseudogout of the temporomandibular joint extending to the base of the skull

Authors:

Kudoh K et al.

Int J Oral Maxillofac Surg.
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