title: Evaluation of the TMJ by means of clinical TMD examination and MRI diagnostics in patients with rheumatoid arthritis.
abstract: This study included 30 patients with diagnosed rheumatoid arthritis (RA) and 30 test subjects without RA (control group). The objective of the study was to examine both groups for the presence of temporomandibular disorders (TMD) and morphological changes of the temporomandibular joint (TMJ). All individuals were examined using a systematic detailed clinical TMD examination as well as magnetic resonance imaging (MRI). The clinical TMD examination yielded significant differences between the RA patients and the control group concerning crepitus of the TMJ, and palpation tenderness of the masticatory muscles as well as the unassisted mandibular opening. The evaluation of the MRI images for the RA group showed significantly more frequent deformations of the condyle, osteophyte formations and erosions in the condylar compacta, and degenerative changes in the spongiosa. Increased intra-articular accumulation of synovial liquid and signs of inflammatory changes of the spongiosa were only found in the RA group. Statistical analysis showed a significant correlation between crepitus and specific osteoarthrotic changes (MRI), respectively, and between crepitus and a complete anterior disk displacement without reduction (MRI). The duration of the RA disease correlated neither with the anamnestic and clinical dysfunction index by Helkimo nor with RA-specific MRI findings.
authors.affiliation: Private Practice, Hauptstraße 5-7, 63808 Haibach, Germany.
authors.forename: Silke
authors.identifier: 0000-0002-0949-5551
authors.initials: S
authors.lastname: Witulski
authors.affiliation: Center for Radiology, Institute of Diagnostic and Interventional Radiology, Johann Wolfgang Goethe University, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany.
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Vogl
authors.affiliation: Clinic for Orthopedics and Trauma Surgery, Agaplesion Markus Hospital, Wilhelm-Epstein-Straße 4, 60431 Frankfurt, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Rehart
authors.affiliation: Department of Prosthodontics and Materials Science, University of Rostock, Strempelstraße 13, 18057 Rostock, Germany.
authors.forename: Peter
authors.identifier: 0000-0002-3304-323X
authors.initials: P
authors.lastname: Ottl
mesh_terms: D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000150:complications*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D013704:Temporomandibular Joint / Q000473:pathology*; D013705:Temporomandibular Joint Disorders / Q000150:complications / Q000175:diagnosis* / Q000473:pathology*