Fredriksson Lars, Alstergren Per, Kopp Sigvard
Department of Clinical Oral Physiology, Institute of Odontology, Karolinska Institute, Huddinge, Sweden.
J Orofac Pain. 2003 Fall;17(4):326-32.
To determine the temporomandibular joint (TMJ) pressure pain threshold (PPT) in female patients with rheumatoid arthritis (RA) and TMJ involvement in comparison with healthy females, in order to determine its clinical usefulness for local pain assessment.
Forty-two female patients with the diagnosis of RA, 17 of them positive and 25 negative for rheumatoid factor were investigated, as well as 17 healthy females. A pressure algometer was used to assess the PPT over the TMJ and (as a reference) the center of the glabella. The mean of the second and third TMJ PPT was used in the analysis, and the ratio between the TMJ PPT and the PPT of the reference site (PPT ratio) was calculated. Temporomandibular joint resting pain and pain upon maximum voluntary mouth opening was assessed by a visual analog scale on each side.
The TMJ PPT (median/10th to 90th percentile) and PPT ratio were significantly lower in the RA patients (148/64 to 220 and 0.63/0.40 to 1.01, respectively) than in the healthy individuals (217/111 to 352 and 0.85/0.51 to 1.25), but the overlap was considerable.
This study shows that the PPT of the TMJ in RA patients is lower than in healthy individuals and that it can be used for pain assessment. However, the clinical use of the TMJ PPT and PPT ratio measurements alone is limited from a diagnostic point of view.
确定类风湿关节炎（RA）伴颞下颌关节（TMJ）受累的女性患者的颞下颌关节压力疼痛阈值（PPT），并与健康女性进行比较，以确定其在局部疼痛评估中的临床实用性。
对42例诊断为RA的女性患者进行研究，其中17例类风湿因子阳性，25例阴性，以及17例健康女性。使用压力痛觉计评估颞下颌关节及（作为对照）眉间中点的PPT。分析中采用第二次和第三次颞下颌关节PPT的平均值，并计算颞下颌关节PPT与对照部位PPT的比值（PPT比值）。通过视觉模拟量表评估每侧颞下颌关节静息痛和最大自主开口时的疼痛。
RA患者的颞下颌关节PPT（中位数/第10至90百分位数）和PPT比值（分别为148/64至220和0.63/0.40至1.01）显著低于健康个体（217/111至352和0.85/0.51至1.25），但重叠部分相当大。
本研究表明，RA患者颞下颌关节的PPT低于健康个体，可用于疼痛评估。然而，仅从诊断角度来看，单独使用颞下颌关节PPT和PPT比值测量的临床应用有限。
