Comparison of three radiographic methods in screening of temporomandibular joint involvement in patients with psoriatic arthritis.

Fifty-three randomly selected subjects with psoriatic arthritis (PA) were examined radiographically by means of orthopantomography, transcranial radiography, and transmaxillary radiography. Two examiners graded the radiographic signs of flattening, osteophytes, erosion, and sclerosis. The findings obtained were then compared, to determine the best technique for screening of temporomandibular joint (TMJ) bone changes. Together the techniques showed definite (24%) and possible (6%) changes suggesting TMJ involvement in 31 (30%) of 106 joints. In all projections radiographic signs suggesting TMJ involvement were most frequent in the condyle. Erosion in the condyle was the most frequent finding. Agreement with regard to definite changes in the condyle was found in only one-third to half of the cases. It is concluded that in radiography of the TMJ in subjects with PA a combination of radiographic techniques should be used to obtain maximum information. However, orthopantomography is well suited for screening of TMJ involvement in subjects with PA.