RESEARCH - Targeted assessment of the TMJ in patients with RA

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J Oral Maxillofac Surg. 2008 Sep;66(9):1804-11.

Targeted assessment of the temporomandibular joint in patients with

rheumatoid arthritis.

Bessa-Nogueira RV, Vasconcelos BC, Duarte AP, Góes PS, Bezerra TP.

Oral and Maxillofacial Surgery, University of Pernambuco, Recife, Brazil.

PURPOSE: This observational study was done to identify the signs and

symptoms of temporomandibular joint (TMJ) involvement in patients with

rheumatoid arthritis (RA) and to assess the association between these

and quantitative measurements for the evaluation of rheumatologic

disease.

PATIENTS AND METHODS: The sample comprised 61 patients suffering from

RA whose signs and symptoms of TMJ were recorded by means of a

questionnaire (scale of limited mandibular function) and clinical

measurements (pain during jaw movement, limitation of maximal mouth

opening, joint sounds, tenderness on TMJ palpation, tenderness on

masticatory muscle palpation). These findings were correlated with the

quantitative measurements for evaluating RA: duration of the disease,

positivity for rheumatoid factor, Health Assessment Questionnaire

(HAQ) score, number of edematous and painful joints, and overall

assessment of functional status.

RESULTS: In terms of overall figures, 70.5% of the patients presented

with at least 1 sign or symptom, 49.2% had at least 1 symptom, and

54.1% had at least 1 sign. The variable pain on movement was

associated with the number of painful joints and the overall

assessment findings (P < .05). Sound on movement was positively

associated with the number of edematous joints (P = .0291). The scale

of limited mandibular function was statistically significantly

correlated with 4 quantitative measurements (P = .0283 to .0448). The

variable pain on palpation of the masticatory muscles was associated

with the number of painful joints (P = .0023). Pain on palpation of

the TMJ was statistically significantly associated with the HAQ score

(P = .0344) and with the number of painful joints (P = .0006).

CONCLUSION: A significant percentage of the patients with RA have

signs and symptoms of TMJ involvement, and the scale of limited

mandibular function proved to be an important measurement tool.

PMID: 18718386

http://www.ncbi.nlm.nih.gov/pubmed/18718386

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