Calcium pyrophosphate deposition disease in the temporomandibular joint: Report of two cases

Calcium pyrophosphate dihydrate (CPPD) crystal deposition disease is characterized by the presence of CPPD crystals in or around the joint. The condition may mimic other joint conditions such as gout, rheumatoid arthritis, degenerative joint disease, and neuroarthropathy joint disease. The term pyrophosphate arthropathy is used to describe the structural damage to the joint occurring with CPPD crystal deposition disease simulating degenerative joint disease; the term pseudogout is applied to intermittent acute attacks of arthritis. Asymptomatic CPPD crystal deposition is probably more common than symptomatic disease, and is characterized by linear and punctate radiodensities in the meniscus or in the articular cartilage. This is also called chondrocalcinosis can be seen in asymptomatic CPPD crystal deposition disease as well as in pseudogout and pyrophosphate arthropathy. The knee is the most commonly affected joint, followed by the wrist and hand. CPPD in the temporomandibular joint (TMJ) is rare, with only 18 cases found in the literature. This report describes the clinical, radiologic, and pathologic findings in 2 TMJ cases and reviews the literature.