Clinical and magnetic resonance imaging findings of the temporomandibular joint and masticatory muscles in patients with rheumatoid arthritis
Clinical and magnetic resonance imaging findings of the temporomandibular joint and masticatory muscles in patients with rheumatoid arthritis
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DOI：
10.1007/s00296-010-1743-4
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发表时间：
2012-05-01
影响因子：
4
通讯作者：
Akdag, Cevriye
中科院分区：
文献类型：
--
作者：
Yilmaz, Hasan Huseyin;Yildirim, Derya;Akdag, Cevriye
本研究旨在探讨类风湿关节炎(RA)患者颞下颌关节(TMJ)和咀嚼肌的临床、X线和磁共振成像(MRI)表现。28例类风湿关节炎患者和29例健康体检者参与研究。患者接受了临床和实验室检查。计算DAS28评分。用侧位X线片评价髁突的侵蚀和移位情况。用头面部MRI测量TMJ、咬肌、翼内、外肌厚度和横截面积。结果发现，RA组的平均最大切迹间距离、外侧范围、后退(P<；0.05)和前伸活动度均小于RA组。侧位X线片显示10.7%(3/28)的RA患者有明显的骨质侵蚀，53.6%(15/28)的RA患者关节突运动受限。2例类风湿关节炎患者侧位X线片均为RF阴性，DAS28评分分别为3.41和4.61。MRI表现为1例类风湿关节炎患者的髁突侵蚀和渗出，另1例患者的咀嚼肌萎缩改变。类风湿性关节炎患者的咀嚼肌厚度和横截面积与健康组比较无统计学意义。回归分析显示RA组左、右肌厚度与横截面积呈强线性关系。TMJ症状是常见的表现，被认为与RA的平均病程有关。应考虑与疾病活动相关的TMJ参与的实验室检查结果。RA患者未出现肌肉萎缩或肥大。
The aim of this study was to investigate the clinical, radiographic, and magnetic resonance imaging (MRI) findings of temporomandibular joint (TMJ) and masticatory muscles in rheumatoid arthritis (RA) patients. Twenty-eight RA patients and 29 healthy subjects were participated in the study. The patient underwent clinical and laboratory investigation. DAS28 scores were calculated. Lateral panoramic radiography was performed to evaluate condylar erosion and condylar movement. Craniofacial MRI was performed to evaluate TMJ and masseter, medial and lateral pterygoid muscles' thickness, and cross-sectional area. It was found that the mean maximal interincisal distance, range of lateral, retrusive (P < 0.05) and protrusive motion were all lesser in RA group. Lateral panoramic radiography revealed a distinct erosion in 10.7% (3/28) and restricted condylar movement in 53.6% (15/28) of RA patients. Two RA patients demonstrating marked condylar erosion in lateral panoramic radiographs were RF negative and had DAS28 scores 3.41 and 4.61. MRI findings revealed condylar erosion and effusion in one RA patient and atrophic changes of masticatory muscles in another patient. There was no statistical significance between RA and healthy groups for the thickness and cross-sectional areas of the masticatory muscles. RA group revealed a strong linear relationship for the right and left muscle thickness and cross-sectional areas in regression analysis. TMJ symptoms are frequent findings and thought to be affected from mean disease duration in RA. Laboratory findings should be considered for disease activity-related TMJ involvement. RA patients did not present muscular atrophy or hypertrophy.