Abstract
We report an unusual case of calcium pyrophosphate dihydrate (CPPD) crystal deposition involving the temporomandibular joint (TMJ) of a 51-year-old woman. The patient presented with a 20-year history of right TMJ clicking sounds without pain and had a locking duration of 6 months with pain. The medical history was unremarkable, and there was no history of disease involving any other joints. There was moderately limited translation of the right condyle and a slight deviation of the mandible to the right during mouth opening. Radiological examination revealed mild bony changes of right condyle, but showed no calcified mass. MRI disclosed anterior disc displacement without reduction. We performed arthrocentesis of the right TMJ and discovered CPPD crystals in the patient's irrigation solution after centrifugation. The crystals were examined by compensated polarized light microscopy and by light microscopy with alizarin red staining. These observations led to a diagnosis of CPPD arthritis of the TMJ. After a 5 years of follow-up, no signs or symptoms of recurrence have been observed.
