Acute temporomandibular arthritis in a patient with bruxism and calcium pyrophosphate deposition disease.

The temporomandibular joint has been regarded as “gout-proof’ ( I ) . Calcium pyrophosphate deposition disease (CPDD) is also unusual at this site. There has been a report of a painless destructive lesion tantamount to a calcium pyrophosphate (CaPPi) tophus involving this joint; it occurred without history of acute attacks in the area (2). Involvement of the temporomandibular joint is not mentioned in standard textbook discussions of CPDD. Several authors who reported large series of cases of CPDD, listing involved joints, failed to note attacks involving this joint (3-7). Similarly, in the unpublished experience of our clinic, which has had 76 cases of CPDD, involvement of this joint was not apparent except for the 1 patient reported here, a man with bruxism. Case Report. A 56-year-old man was referred to our arthritis clinic because of pain and swelling at the left temporomandibular joint of 3 weeks duration and at the right wrist of 1 week duration. Two years previously, an attack of pain and swelling occurred in 1 foot, preventing walking for a week before it resolved completely. The patient’s wife of 30 years reported that he had had loud attacks of nocturnal bruxism all of their married life. In spite of this, he had