Arora Pallak, Amarnath Janardhan, Ravindra Setru Veerabhadrappa, Rallan Mandeep
Department of Oral Medicine and Radiology, Kalka Dental College Hospital and Research Centre, Meerut, Uttar Pradesh, India.
BMJ Case Rep. 2013 May 2;2013:bcr2013009386. doi: 10.1136/bcr-2013-009386.
Frequency of temporomandibular joint (TMJ) involvement in patients with ankylosing spondylitis (AS) has varied from 4% to 35%. It is more common in men and produces generalised stiffness in involved joints. Clinician should be suspicious of AS when a patient reports with painful restricted movements of joint, neck or back and with no trauma history. Conventional radiographic methods have allowed the demonstration of TMJ abnormalities in patients with AS, but CT is necessary to establish joint space relations and bony morphology. We describe a case of severe AS with TMJ involvement in a 40-year-old female patient and demonstrated TMJ changes on CT. A CT was able to demonstrate articular cartilage changes, disc- and joint abnormalities. Thus, if conventional radiographs in a symptomatic patient with rheumatic diseases are unable to demonstrate changes, CT can provide valuable additional information of the changes in the TMJ.
强直性脊柱炎(AS)患者颞下颌关节(TMJ)受累的频率在4%至35%之间。在男性中更为常见,并会导致受累关节出现全身性僵硬。当患者报告关节、颈部或背部疼痛且活动受限且无外伤史时,临床医生应怀疑为AS。传统的放射学方法已能显示AS患者的颞下颌关节异常,但需要CT来确定关节间隙关系和骨质形态。我们描述了一例40岁女性严重AS患者合并颞下颌关节受累的病例,并在CT上显示了颞下颌关节的变化。CT能够显示关节软骨变化、盘状和关节异常。因此,如果有症状的风湿性疾病患者的传统X线片无法显示变化,CT可以提供有关颞下颌关节变化的有价值的额外信息。