employee from 01.01.2021 until now
St. Petersburg, St. Petersburg, Russian Federation
employee
Saint Peterburg, St. Petersburg, Russian Federation
Saint Peterburg, St. Petersburg, Russian Federation
employee
Saint Peterburg, St. Petersburg, Russian Federation
employee
Saint Peterburg, St. Petersburg, Russian Federation
UDC 616.31
CSCSTI 76.29
Introduction. Temporomandibular joint disorders in rheumatoid arthritis may have specific characteristics. The presence of various nosological forms of diseases and their combination creates additional challenges in developing a universal diagnostic protocol. The aim of the study was to investigate different manifestations of temporomandibular joint diseases in patients with rheumatoid arthritis and their differential diagnosis. Material and methods. The study was conducted on the basis of St. Petersburg "Clinical Rheumatological Hospital № 25" and "Clinic of Dentistry" of the Research Institute of Dentistry and maxillofacial surgery. The study included 20 patients aged 21 to 68 years with TMJ disorders against the background of rheumatoid arthritis. Subjective indicators, data of objective clinical examination and MRI findings were studied. Results. Patients with TMJ disorders against the background of rheumatoid arthritis most frequently complain of pain (95 %), sound symptoms (90 %), limited mouth opening (80 %) and parafunction of the masticatory muscles (70 %). Among the objective findings there was a high frequency of pathological sounds in TMJ (85 %), hypertonus of masticatory muscles (80 %), a lack of mouth opening and deviated trajectory of mouth opening (70 % each), and muscle pain upon palpation (20 %). MRI results revealed displacement of articular disc (100 %), mandible condyle displacement (65 %), the flattening of the articular surfaces (60 %), osteophytes (55 %), bone erosion (50 %), destruction of the articular surfaces (15 %) and synovial proliferation (10 %). In patients with rheumatoid arthritis, various options of the TMJ disorders are formed, mostly not inflammatory in nature – arthrosis (75 %), Costen syndrome (55 %), "Snapping jaw" (40 %). TMJ arthritis was diagnosed only in 35 % of cases. Conclusions. For a complete differential diagnosis of variants of temporomandibular joint diseases, it is recommended to perform magnetic resonance tomography along with clinical examination. Temporomandibular joint disorders in patients with rheumatoid arthritis have different etiology and variations in progression that must be taken into account when planning treatment stages
rheumatoid arthritis, temporomandibular joint, temporomandibular disorders, MRI diagnostics, differential diagnosis
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