Clinical radiographic and MRI findings of the temporomandibular joint in patients with different rheumatic diseases
Clinical radiographic and MRI findings of the temporomandibular joint in patients with different rheumatic diseases
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DOI：
10.1016/j.ijom.2006.08.001
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发表时间：
2006-11-01
影响因子：
2.4
通讯作者：
Leirisalo-Repo, M.
中科院分区：
文献类型：
--
作者：
Helenius, L. M. J.;Tervahartiala, P.;Leirisalo-Repo, M.
本研究的目的是调查不同风湿性疾病患者的颞下颌关节(TMJ)的情况，并报告临床、X线和磁共振成像(MRI)所见之间的相关性。67例患者分为4组：类风湿关节炎(RA)16例，混合性结缔组织病(MCTD)15例，强直性脊柱炎(AS)18例，脊柱关节病(SPA)18例。对患者进行临床检查，并进行TMJ全景体层摄影、侧位X线片及MRI检查。MRI显示RA患者关节软骨减少25%(4/16)，MCTD患者为0%(0/15)，AS患者为17%(3/18)，SPA患者为17%(3/18)。髁突的改变包括侵蚀、骨赘和形态异常。椎间盘改变包括穿孔、前位异常和活动度降低。这些异常在RA患者中最常见，在MCTD和SPA患者中最少见。MRI显示，皱纹和最大张口度降低与关节盘和关节软骨的异常有关。MRI表现为髁状突侵蚀(P<；0.01)、软骨厚度减薄、髁状突形态异常及颞面形态异常(P<0.05)，与CT表现呈显著正相关。
The aim of this study was to investigate the condition of the temporomandibular joint (TMJ) in patients with different rheumatic diseases, and report correlations between the clinical, radiographic and magnetic resonance imaging (MRI) findings. The 67 patients were divided into four groups: 16 with rheumatoid arthritis (RA), 15 with mixed connective tissue disease (MCTD), 18 with ankylosing spondylitis (AS) and 18 with spondyloarthropathy (SPA). They were clinically examined, and panoramic tomography, lateral panoramic radiography and MRI of the TMJ were performed. MRI showed reduced articular cartilage in 25% (4/16) of RA, 0% (0/15) of MCTD, 17% (3/18) of AS and 17% (3/ 18) of SPA patients. Condylar changes included erosion, osteophytes and abnormal shape. Disc alterations included perforation, abnormal anterior position and decreased movement. These abnormalities were most frequent in RA patients, and least frequent in MCTD and SPA patients. Crepitation and reduced maximum opening of the mouth correlated with abnormalities of the disc and articular cartilage as shown by MRI. Severe condylar erosion in panoramic tomograms significantly correlated with MRI findings of condylar erosion (P < 0.01), diminished thickness of condylar cartilage, abnormal condylar shape, and abnormal shape of the temporal surface of the TMJ (P