Temporomandibular Joint Involvement in Rheumatoid Arthritis: A Radiological and Clinical Study

ABSTRACT

Temporomandibular joint (TMJ) involvement in rheumatoid arthritis (RA) is not uncommon. In this study a questionnaire, clinical assessment, and high resolution computerized tomography (HRCT) were used in 15 patients with rheumatoid arthritis to evaluate the diagnostic criteria of TMJ involvement. Symptoms due to TMJ involvement were present in 33.3% of the patients. Frequency of involvement was 40.0% on clinical assessment but 86.6% with HRCT assessment. The most common HRCT findings were decreases in the joint space (33.3%), mandibular subchondral cysts (23.3%), temporal subchondral cysts (23.3%), degeneration (23.3%), shape (13.3%) and height (13.3%) anomalies of the mandibular condyle, condylar head resorption (13.3%), erosion of the mandibular condyle (13.3%), and demineralization (13.3%). All patients with positive clinical findings also had positive HRCT findings. In seven (46.7%) of the patients, there were no symptoms or clinical findings implying TMJ involvement; however, they had positive results on HRCT evaluation. The HRCT findings may be the initial sign of TMJ involvement in patients with rheumatoid arthritis. In conclusion, it is suggested that RA patients with the suspicion of TMJ involvement should undergo HRCT evaluation, because HRCT findings may precede the clinical findings.

Additional information

Notes on contributors

Nuray Bayar

Dr. Nuray Bayar graduated from Hacettepe University, Faculty of Medicine in 1990. She became an Ear Nose Throat (ENT) and Head and Neck Surgery specialist at Hacettepe University Faculty of Medicine in 1994. She studied at Ruhi Tingiz State Hospital between 1995–1997. Currently she is working as an Assistant Professor at Kirikkale University, Faculty of Medicine, ENT Department. Dr. Bayar has published several scientific medical articles.

Simay Altan Kara

Dr. Simay Altan Kara graduated from Hacettepe University, Faculty of Medicine in 1990. She became a Radiology specialist at Ankara University Faculty of Medicine in 1995. She studied at Kanazawa University Faculty of Medicine Hospital in Japan between 1999–2000. She has been working as an assistant professor at Kirikkale University, Faculty of Medicine, Radiology Department since 2000. Dr. Kara has published several scientific medical articles.

Isik Keles

Dr. Isik Keles graduated from Ankara University, Faculty of Medicine in 1992. He became a Physical Medicine and Rehabilitation specialist at Gazi University Faculty of Medicine in 1997. He studied at Ankara Rehabilitation Center between 1998–1999. Currently, Dr. Keles is working as an Assistant Professor at Kirikkale University, Faculty of Medicine, Physical Medicine and Rehabilitation Department.

M. Can Koç

Dr. M. Can Koç graduated from Hacettepe University, Faculty of Medicine in 1986. He became an Ear Nose Throat (ENT) and Head and Neck Surgery specialist at Numune State Hospital in 1990. He studied at Numune State Hospital in 1990, between 1992–1993, and 1996–2000. He studied at Ruhr University in Germany in 1991 and at Graz University, Austria between 1994–1995. He became an Associate Professor in 1996. He has been an Associate Professor at Kirikkale University, Faculty of Medicine, ENT Department since 2000. Dr. Koç has published several scientific medical articles.

Deniz Altinok

Dr. Deniz Altinok graduated from Hacettepe University, Faculty of Medicine in 1989. He became a Radiology specialist at Hacettepe University Faculty of Medicine in 1995. He studied at University of Michigan Hospital in the United States between 1995–1996. He became an Assistant Professor at Kirikkale University, Faculty of Medicine, Radiology Department in 2000. He became an Associate Professor in 2000. Currently, Dr. Altinok is an Associate Professor at Kirikkale University, Faculty of Medicine, Radiology Department. He has published several scientific medical articles.

Sevim Orkun

Dr. Sevim Orkun graduated from Istanbul University, Faculty of Medicine in 1974. She became a Physical Medicine and Rehabilitation specialist at Ankara University, Faculty of Medicine in 1981. She studied at Ankara Rehabilitation Center between 1987–1998. She became an Associate Professor in 1994. She has been working at Kirikkale University, Faculty of Medicine, Physical Medicine and Rehabilitation Department from 1998 until now. She became a Professoral Kirikkale University, Faculty of Medicine, Physical Medicine and Rehabilitation Department in 2000 and a Dean Assistant in 2000. Dr. Orkun has published other scientific medical articles.