Volume 16, Number 1, March 2004

Magnetic Resonance Imaging Findings in Rheumatoid Arthritis Patients with Temporomandibular Joint Disorder

Toshihiro Okamoto, Shiro Matuoka, Kenji Fukada, Setuko Ito, Ryo Sasaki, Chiyuki Komiya, Takaho Kuwazawa, Tomohiro Ando, Hideki Ogiuchi

Department of Oral and Maxillofacial Surgery, Tokyo Women's Medical University, Shinjuku-ku, Tokyo, Japan


Abstract
Objective: To evaluate the ability of magnetic resonance imaging to identify temporomandibular joint involvement in patients with rheumatoid disease.
Patients and Methods: Eight patients with temporomandibular joint symptoms of pain and impaired function, who satisfied the 1987 criteria of the American College of Rheumatology for rheumatoid arthritis were enrolled. Clinical findings in the masticatory system were recorded. Open and closed mouth sagittal proton-density and T2-weighted sequences were performed for all patients, and the images were examined for condylar configuration, presence of erosion, disc position, and disc abnormality.
Results: Four of the 8 patients had mild rheumatoid arthritis activity, 2 had moderate activity and rheumatoid arthritis was inactive in the other 2 patients. Six of the 8 patients had Steinbrocker's class II disease and the others had class III disease. Seven of the 8 patients had temporomandibular joint tenderness or jaw opening pain. Coarse crepitus on opening (5 temporomandibular joints) was the commonest joint sound abnormality. Anterior disc displacement without reduction was present in 6 patients and pannus in 2 patients. Condylar deformity was present in all patients. Four patients showed joint effusion.
Conclusion: The results of this study clearly demonstrated the ability of magnetic resonance imaging to detect and define abnormalities in the temporomandibular joint of patients with rheumatoid arthritis.


Key words: Magnetic resonance imaging, Rheumatoid arthritis, Temporomandibular disorder

Asian J Oral Maxillofac Surg. 2004;16:10-14.
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