DOI QR코드

DOI QR Code

A Large Subchondral Cyst in an Osteoarthritic Temporomandibular Joint: A Case Report

  • Jeon, Hye-Mi (Dental Clinic Center, Pusan National University Hospital) ;
  • Ahn, Yong-Woo (Department of Oral Medicine, Pusan National University Dental Hospital, Dental Research Institute) ;
  • Ok, Soo-Min (Department of Oral Medicine, Pusan National University Dental Hospital, Dental Research Institute) ;
  • Ju, Hye-Min (Department of Oral Medicine, Pusan National University Dental Hospital, Dental Research Institute) ;
  • Jung, Kyung-Hwa (Dental Clinic Center, Pusan National University Hospital) ;
  • Kwon, Eun-Young (Dental Clinic Center, Pusan National University Hospital) ;
  • Jeong, Sung-Hee (Department of Oral Medicine, Pusan National University Dental Hospital, Dental Research Institute)
  • 투고 : 2022.02.09
  • 심사 : 2022.03.04
  • 발행 : 2022.03.30

초록

Subchondral cysts are frequently encountered in patients with temporomandibular joint osteoarthritis (TMJ OA), particularly in advanced stage. Subchondral cysts within osteoarthritis are typically lying adjacent to the joint surface where initial load bearing occurs during activity and have been associated with greater pain and disease progression. Although the etiology of these cysts remains uncertain, recently studies report that the induction of the subchondral bone mechanical stress caused subchondral cysts. Repeated overloading leads to further deterioration of subchondral bone which render subchondral bone structure more fragile, increase the risk of osteoarthritis progress. The purpose of this study was to assess the effect of conservative treatment and longitudinal osseous changes of a large subchondral cyst in a mandibular condyle in a symptomatic TMJ OA patient.

키워드

과제정보

This study was supported by a Clinical Research Grant from Pusan National University Hospital (2021).

참고문헌

  1. Li G, Yin J, Gao J, et al. Subchondral bone in osteoarthritis: insight into risk factors and microstructural changes. Arthritis Res Ther 2013;15:223. https://doi.org/10.1186/ar4405
  2. Ju HM, Kim KH, Jeong SH, Ahn YW, Ok S. Pathophysiology of temporomandibular joint arthritis: review. J Oral Med Pain 2021;46:69-74. https://doi.org/10.14476/jomp.2021.46.3.69
  3. Honda K, Larheim TA, Maruhashi K, Matsumoto K, Iwai K. Osseous abnormalities of the mandibular condyle: diagnostic reliability of cone beam computed tomography compared with helical computed tomography based on an autopsy material. Dentomaxillofac Radiol 2006;35:152-157. https://doi.org/10.1259/dmfr/15831361
  4. Massilla Mani F, Sivasubramanian SS. A study of temporomandibular joint osteoarthritis using computed tomographic imaging. Biomed J 2016;39:201-206. https://doi.org/10.1016/j.bj.2016.06.003
  5. Kaspiris A, Khaldi L, Grivas TB, et al. Subchondral cyst development and MMP-1 expression during progression of osteoarthritis: an immunohistochemical study. Orthop Traumatol Surg Res 2013;99:523-529. https://doi.org/10.1016/j.otsr.2013.03.019
  6. McErlain DD, Ulici V, Darling M, et al. An in vivo investigation of the initiation and progression of subchondral cysts in a rodent model of secondary osteoarthritis. Arthritis Res Ther 2012;14:R26. https://doi.org/10.1186/ar3727
  7. Guven M, Ozler T, Kocadal O, Ozkan F, Altintas F. An atypically located large subchondral cyst in an osteoarthritic hip joint: a case report. J Med Case Rep 2013;7:176. https://doi.org/10.1186/1752-1947-7-176
  8. Comert Kilic S, Kilic N, Sumbullu MA. Temporomandibular joint osteoarthritis: cone beam computed tomography findings, clinical features, and correlations. Int J Oral Maxillofac Surg 2015;44:1268-1274. https://doi.org/10.1016/j.ijom.2015.06.023
  9. Burr DB, Gallant MA. Bone remodelling in osteoarthritis. Nat Rev Rheumatol 2012;8:665-673. https://doi.org/10.1038/nrrheum.2012.130
  10. Wang XD, Zhang JN, Gan YH, Zhou YH. Current understanding of pathogenesis and treatment of TMJ osteoarthritis. J Dent Res 2015;94:666-673. https://doi.org/10.1177/0022034515574770
  11. Tanamas SK, Wluka AE, Pelletier JP, et al. The association between subchondral bone cysts and tibial cartilage volume and risk of joint replacement in people with knee osteoarthritis: a longitudinal study. Arthritis Res Ther 2010;12:R58. https://doi.org/10.1186/ar2971
  12. Durr HD, Martin H, Pellengahr C, Schlemmer M, Maier M, Jansson V. The cause of subchondral bone cysts in osteoarthrosis: a finite element analysis. Acta Orthop Scand 2004;75:554-558. https://doi.org/10.1080/00016470410001411
  13. Resnick D, Niwayama G, Coutts RD. Subchondral cysts (geodes) in arthritic disorders: pathologic and radiographic appearance of the hip joint. AJR Am J Roentgenol 1977;128:799-806. https://doi.org/10.2214/ajr.128.5.799
  14. Landells JW. The bone cysts of osteoarthritis. J Bone Joint Surg Br 1953;35-B:643-649. https://doi.org/10.1302/0301-620X.35B4.643
  15. Ondrouch AS. Cyst formation in osteoarthritis. J Bone Joint Surg Br 1963;45:755-760. https://doi.org/10.1302/0301-620X.45B4.755
  16. Kelly MP, Kitamura N, Leung SB, Engh CA Sr. The natural history of osteoarthritic bone cysts after uncemented total hip arthroplasty. J Arthroplasty 2007;22:1137-1142. https://doi.org/10.1016/j.arth.2006.11.006
  17. McErlain DD, Milner JS, Ivanov TG, Jencikova-Celerin L, Pollmann SI, Holdsworth DW. Subchondral cysts create increased intra-osseous stress in early knee OA: a finite element analysis using simulated lesions. Bone 2011;48:639-646. https://doi.org/10.1016/j.bone.2010.11.010
  18. Tanaka E, Liu Y, Xia L, et al. Effectiveness of low-intensity pulsed ultrasound on osteoarthritis of the temporomandibular joint: a review. Ann Biomed Eng 2020;48:2158-2170. https://doi.org/10.1007/s10439-020-02540-x