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Case Reports
. 2015 Jan-Mar;6(1):124-7.
doi: 10.4103/0976-237X.149308.

Rheumatoid arthritis affecting temporomandibular joint

Amandeep Sodhi  1 , Shobha Naik  2 , Anuradha Pai  1 , Ardra Anuradha  1
Affiliations
Case Reports

Rheumatoid arthritis affecting temporomandibular joint

Amandeep Sodhi et al. Contemp Clin Dent. 2015 Jan-Mar.

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.

Keywords: Cone beam computed tomography; rheumatoid arthritis; temporomandibular joint.

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Conflict of interest statement

Conflict of Interest: None declared.

Figures

Figure 1
Figure 1
Extra oral photograph showing restricted mouth opening
Figure 2
Figure 2
Orthopantomogram showing no appreciable changes in the left condyle
Figure 3
Figure 3
Temporomandibular joint (TMJ) tomogram revealing mild erosions at the anterior condyle of left TMJ
Figure 4a
Figure 4a
CBCT coronal view of closed mouth – a) right condyle revealing slight decrease in joint space
Figure 4b
Figure 4b
Left condyle revealing loss of joint space and severe condylar erosions
Figure 5
Figure 5
Coronal view of open mouth – (a) right side depictingno changes in the joint space (b) Left side revealing narrowing of the articular space and erosions on superior head of the condyle
Figure 6
Figure 6
Sagittal view open mouth: (a) right side depicting nochanges (b) decreased joint space and erosions of the superior surface of the condyle
Figure 7
Figure 7
Hand wrist radiograph revealing the joint space narrowing of the distal phalange of the right thumb, narrowing of 3rd and 4th proximal phalanges and erosion of the middle phalange seen of index finger
Figure 8
Figure 8
(a) Radiograph of right shoulder joint and knee joint revealing no changes. (b) Radiograph of right shoulder joint and knee joint revealing no changes
See this image and copyright information in PMC

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