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Rheumatoid arthritis affecting temporomandibular joint.

Sodhi A, Naik S, Pai A, Anuradha A - Contemp Clin Dent (2015 Jan-Mar)

Bottom Line: Temporomandibular joint (TMJ) is very rare to be affected in the early phase of the disease, thus posing diagnostic challenges for the dentist.More recently cone-beam computed tomography (CBCT) has been found to diagnose the early degenerative changes of TMJ and hence aid in the diagnosis of the lesions more accurately.Our case highlights the involvement of TMJ in RA and the role of advanced imaging (CBCT) in diagnosing the bony changes in the early phase of the disease.

View Article: PubMed Central - PubMed

Affiliation: Department of Oral Medicine and Radiology, The Oxford Dental College and Hospital, Bangalore, Karnataka, India.

ABSTRACT
Rheumatoid arthritis (RA) is a chronic, systemic, autoimmune inflammatory disorder that is characterized by joint inflammation, erosive properties and symmetric multiple joint involvement. Temporomandibular joint (TMJ) is very rare to be affected in the early phase of the disease, thus posing diagnostic challenges for the dentist. Conventional radiographs fail to show the early lesions due to its limitations. More recently cone-beam computed tomography (CBCT) has been found to diagnose the early degenerative changes of TMJ and hence aid in the diagnosis of the lesions more accurately. Our case highlights the involvement of TMJ in RA and the role of advanced imaging (CBCT) in diagnosing the bony changes in the early phase of the disease.

No MeSH data available.


Related in: MedlinePlus

Orthopantomogram showing no appreciable changes in the left condyle
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Figure 2: Orthopantomogram showing no appreciable changes in the left condyle

Mentions: A 22-year-old female patient visited the outpatient department with a complaint of pain in the left jaw joint region since 1½ months. On eliciting the history, patient had pain on mastication and difficulty in opening the mouth due to which she was on the soft diet. Medical history revealed that she was diagnosed with RA 6 months back. The patient took homeopathy medicines for 1 month. But presently was not on any medication. On clinical examination of TMJ, the following signs and symptoms were assessed: Left side TMJ was associated with pain, TMJ range of motion was limited, associated with pain while maximum unassisted mouth opening (18 mm) and while lateral excursion [Figure 1], deviation of mandible toward left side while opening mouth was noticed. No clicking sounds on opening, closing and lateral movements. Muscles of mastication were tender on palpation. Intra orally, no teeth were carious, no occlusal prematurity was noticed. On radiological examination, panoramic radiograph depicted irregular erosions in the left condyle and decreased joint space both on right and left side. The findings were of degenerative joint disease but nonspecific due to the overlapping of structures [Figure 2]. TMJ tomography both open and closed mouth revealed slight erosion in the anterior surface of the left condyle but was not clearly appreciated [Figure 3]. Further evaluation was carried out by CBCT.


Rheumatoid arthritis affecting temporomandibular joint.

Sodhi A, Naik S, Pai A, Anuradha A - Contemp Clin Dent (2015 Jan-Mar)

Orthopantomogram showing no appreciable changes in the left condyle
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4319332&req=5

Figure 2: Orthopantomogram showing no appreciable changes in the left condyle
Mentions: A 22-year-old female patient visited the outpatient department with a complaint of pain in the left jaw joint region since 1½ months. On eliciting the history, patient had pain on mastication and difficulty in opening the mouth due to which she was on the soft diet. Medical history revealed that she was diagnosed with RA 6 months back. The patient took homeopathy medicines for 1 month. But presently was not on any medication. On clinical examination of TMJ, the following signs and symptoms were assessed: Left side TMJ was associated with pain, TMJ range of motion was limited, associated with pain while maximum unassisted mouth opening (18 mm) and while lateral excursion [Figure 1], deviation of mandible toward left side while opening mouth was noticed. No clicking sounds on opening, closing and lateral movements. Muscles of mastication were tender on palpation. Intra orally, no teeth were carious, no occlusal prematurity was noticed. On radiological examination, panoramic radiograph depicted irregular erosions in the left condyle and decreased joint space both on right and left side. The findings were of degenerative joint disease but nonspecific due to the overlapping of structures [Figure 2]. TMJ tomography both open and closed mouth revealed slight erosion in the anterior surface of the left condyle but was not clearly appreciated [Figure 3]. Further evaluation was carried out by CBCT.

Bottom Line: Temporomandibular joint (TMJ) is very rare to be affected in the early phase of the disease, thus posing diagnostic challenges for the dentist.More recently cone-beam computed tomography (CBCT) has been found to diagnose the early degenerative changes of TMJ and hence aid in the diagnosis of the lesions more accurately.Our case highlights the involvement of TMJ in RA and the role of advanced imaging (CBCT) in diagnosing the bony changes in the early phase of the disease.

View Article: PubMed Central - PubMed

Affiliation: Department of Oral Medicine and Radiology, The Oxford Dental College and Hospital, Bangalore, Karnataka, India.

ABSTRACT
Rheumatoid arthritis (RA) is a chronic, systemic, autoimmune inflammatory disorder that is characterized by joint inflammation, erosive properties and symmetric multiple joint involvement. Temporomandibular joint (TMJ) is very rare to be affected in the early phase of the disease, thus posing diagnostic challenges for the dentist. Conventional radiographs fail to show the early lesions due to its limitations. More recently cone-beam computed tomography (CBCT) has been found to diagnose the early degenerative changes of TMJ and hence aid in the diagnosis of the lesions more accurately. Our case highlights the involvement of TMJ in RA and the role of advanced imaging (CBCT) in diagnosing the bony changes in the early phase of the disease.

No MeSH data available.


Related in: MedlinePlus