Comparative study between the temporomandibular joints and hands joints in patients with rheumatoid arthritis

Abstract

Study joint damage and its characteristics in Temporomandibular Joint (T.M.J.) of patients with Rheumatoid Arthritis (A.R.) in reference to joints of the same patient´s handTo determine the involvement of Tempormandibular joints (TMJ) in reference to hands joints in patients with rheumatoid arthritis (R.A.)To advance in a methodology for the early diagnosis of diseases affecting the TMJ.This is an observational, descriptive, prospective, cross-sectional and established in series of cases study. We analyzed 50 consecutive patients (over 18 years of age, with informed consent, with a diagnosis of R.A. by EULAR/ACR criteria and any other immunological pathology), who were attended in Rheumatology Services of Córdoba Hospital and Allende Sanatorium. We performed a clinical examination of the oral cavity, with emphasis on TMJ in static and dynamic, high resolution and power doppler ultrasound of TMJ and hands.No patient had spontaneous pain or tinnitus prior or maintained over time. Patients, 28 (56%) had lower mouth opening, 32 (64%) reported altered dynamic condylar and condylar asymmetry, 12 (24%) showed degenerations in inferior condylar head, 30 (60%) had pannus joint and bone erosions, 46 (92%) had joint effusion and 4 (8%) showed capsular distensión.It is known that Rheumatoid Arthritis is an autoimmune systemic inflammatory chronic degenerative and progressive disease characterized by peripheral polyarthritis, generally symmetric of small joints. It causes alterations and disabilities. Categorized as of relevant health importance in Latinamerican countries. It is a pathology with painful disorders mainly of hands and feet. A large percentage of patients with RA have TMJ disturbance, despite to not refer symptoms, perhaps, because they are widely medicated. In this context, the patient does not report pain while the damage progresses. Imaging methods are important guidance and safe markers and should be considered for the prevention and treatment of TMJ disturbance en RA.