Dominant form of arthrogryposis multiplex congenita with limited mouth opening: a clinical and imaging study.
OBJECTIVE
Arthrogryposis multiplex congenita (AMC) is characterized by congenital contractures and joint deformities, but there are only a few reports of temporomandibular joint (TMJ) involvement. The objective of this investigation was to study the cause of limited mouth movement in this disease.


METHODS
Four individuals from a family affected by AMC over 5 generations were examined clinically and by magnetic resonance imaging (MRI) and 3-dimensional computerized tomography (3D-CT).


RESULTS
The CT scans of the 4 individuals showed hyperplasia of the coronoid process protruding into the infratemporal fossa in 2 of them and cranially to the zygomatic arch in the other 2; the hyperplasia was associated with mechanical limitation of the mouth opening. The MRI showed a disc displacement with reduction in 1 patient and a disc displacement without reduction in another; disc displacement could not be evaluated because of the limited mouth opening in the other 2. The condyle-disc complex of these last 2 individuals could only rotate. The MRI on T2-weighted images showed disc hyposignal in all cases but no alterations in the masticatory muscle tissue. The pedigree of the family suggests an autosomal dominant form of inheritance.


CONCLUSIONS
The restriction of mouth opening in the 4 individuals affected by AMC was likely due to osseous dysplasia.
Guimarães
Antonio Sergio
AS
Department of Oral Physiology, Head Institute, São Paulo Federal University (UNIFESP), São Paulo, SP, Brazil. asgatm@uol.com.br
Marie
Suely Kazue Nagahashi
SK
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001176:Arthrogryposis / Q000235:genetics / Q000473:pathology / Q000503:physiopathology*; D002648:Child; D003937:Diagnosis, Differential; D005260:Female; D005799:Genes, Dominant; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008334:Mandible / Q000473:pathology*; D010375:Pedigree; D016059:Range of Motion, Articular; D013704:Temporomandibular Joint / Q000033:anatomy & histology / Q000000981:diagnostic imaging / Q000503:physiopathology*; D013705:Temporomandibular Joint Disorders / Q000175:diagnosis; D014057:Tomography, X-Ray Computed