Examination of temporomandibular joint with magnetic resonance imaging in patients with rheumatoid arthritis

Rheumatoid arthritis (RA) is a chronic, inflammatory disease that affects synovial tissues and joints, including the temporomandibular joint (TMJ). The reported frequency of TMJ involvement in patients with RA ranges between 50-75%. In this study, it was aimed to evaluate the clinical features, physical examination findings and magnetic resonance imaging (MRI) findings of the patients by examining the MRI of the TMJ in patients with RA and the manner of involvement in these patients. The number of subjects was calculated as 40 at the p=0.05 significance level for 80% power. Patients who were previously diagnosed with RA and applied to our clinic with TMJ-related complaints were included in the study. Those with any systemic disease besides RA were excluded from the study. Patients for whom MRI will be requested were questioned whether they had any contraindications. The patients' age, complaints, disease duration, disease activity score, seropositivity, TMJ examination findings and radiological evaluation results were recorded. A total of 44 (40 female, 4 male) patients were included in the study. A total of 88 joints, right and left, were evaluated. The mean age of the patients was 47,73±13,65. The mean duration of illness was 84 (12-384) months. There were complaints of pain in the TMJ region in 22 patients (50%), noise in the joint in 2 patients (5%), and limitation in mouth opening in 20 patients (46%). While the number of patients with a click sound was 22 (50%), the number of patients with crepitation was 26 (59%). On MRI, reducted anterior disc displacement was observed in 21 patients and non-reducted anterior disc displacement in 11 patients. There was cortical irregularity in the TMJ condyle in 33 patients (75%), resorption of the mandibular condyle surfaces in 8 patients (18%), and flattening of the mandibular condyle surface in 17 patients (39%). Osteophyte formation was observed in 28 patients (64%), and a decrease in joint space was observed in 16 patients (36%). While disc perforation was observed in 4 patients (9%), the number of patients with disc degeneration was found to be 29 (66%). The number of patients with effusion was 12 (28%). In our study, TMJ involvement was detected in all RA patients. The frequent TMJ involvement in RA patients shows that TMJ examinations of these patients should not be neglected.