Major P, Ramos-Remus C, Suarez-Almazor M E, Hatcher D, Parfitt M, Russell A S
Department of Oral Health Sciences, University of Alberta, Edmonton, Alberta, Canada.
J Rheumatol. 1999 Mar;26(3):616-21.
To evaluate temporomandibular joint (TMJ) articular disc position and osseous degenerative changes using magnetic resonance imaging (MRI) as well as clinical symptoms of temporomandibular disorders in patients with ankylosing spondylitis (AS).
A sample of 43 patients with AS (38 males, age 45.9+/-10.7 years) and 16 controls (all male, age 41.3+/-6.3 years) were studied. All subjects completed a self-administered questionnaire and underwent clinical examination and MRI survey. Recorded variables included disease characteristics, subjective neck and TMJ disorder symptoms, and axial mobility measurements. MRI variables included TMJ disc position and severity of osseous degenerative change.
TMJ disorder symptoms of headache duration and frequency, TMJ pain duration and frequency, and painful jaw movement were more frequent in patients with AS (p < 0.05). Significant differences were also observed in MRI indices for disc displacement (AS, 0.89; controls, 0.36; p = 0.005) and degenerative changes (AS, 0.55; controls, 0.06; p = 0.01). A total of 50 (62%) joints in the AS group had disc displacement compared to 11 (34%) joints in the controls. A total of 16 (20%) joints in the AS group had degenerative change compared to 2 (6%) joints in the controls.
TMJ internal derangement, degenerative changes, and subjective pain complaints are frequent in patients with AS. Physicians should be aware of potential TMJ involvement in these patients, which may require specific assessment and therapy.
利用磁共振成像（MRI）评估强直性脊柱炎（AS）患者的颞下颌关节（TMJ）关节盘位置及骨质退行性改变，以及颞下颌关节紊乱的临床症状。
研究纳入43例AS患者（38例男性，年龄45.9±10.7岁）和16例对照者（均为男性，年龄41.3±6.3岁）。所有受试者均完成一份自填式问卷，并接受临床检查和MRI检查。记录的变量包括疾病特征、主观颈部和TMJ紊乱症状以及轴向活动度测量。MRI变量包括TMJ盘位置和骨质退行性改变的严重程度。
AS患者中，头痛持续时间和频率、TMJ疼痛持续时间和频率以及下颌疼痛运动等TMJ紊乱症状更为常见（p<0.05）。在盘移位的MRI指标（AS组为0.89；对照组为0.36；p = 0.005）和退行性改变（AS组为0.55；对照组为0.06；p = 0.01）方面也观察到显著差异。AS组共有50个（62%）关节出现盘移位，而对照组为11个（34%）关节。AS组共有16个（20%）关节出现退行性改变，而对照组为2个（6%）关节。
AS患者中TMJ内紊乱、退行性改变和主观疼痛主诉较为常见。医生应意识到这些患者可能存在TMJ受累情况，这可能需要进行特定的评估和治疗。
