Larheim T A, Bjørnland T
Department of Oral Radiology, Faculty of Dentistry, University of Oslo, Norway.
J Oral Maxillofac Surg. 1989 Aug;47(8):780-4. doi: 10.1016/s0278-2391(89)80033-3.
Hypocycloidal multisection tomography and lower-space arthrotomography with videofluoroscopy were performed on 20 symptomatic temporomandibular joints (TMJs) of 17 patients. All patients (16 women, one man, aged 17 to 38 years) had definite or suspected rheumatoid arthritis (adult or juvenile type), ankylosing spondylitis, or psoriatic arthropathy. Bone abnormalities were found in 14 TMJs, primarily cortical erosion (11 joints), but also condylar flattening (three joints). Irregularity in outline of the contrast material, bone contour-contrast material gaps, evidence of adherent discs and/or small joint compartments indicated synovial hyperplasia/pannus formation in 15 joints. Six of these (four with normal disc position) showed perforation between the joint compartments. In those with normal disc position the perforation seemed to occur in the central portion. Ten of the 15 joints had normal disc position; the remaining five had anterior disc displacement without reduction. One joint showed only disc displacement. Most joints with bone abnormalities (12 of 14) showed arthrographic signs of rheumatic involvement. Such signs were also observed in two of the six joints with no bone abnormalities, indicating the value of arthrography in the early diagnosis of patients with rheumatic disease and TMJ problems.
对17例患者的20个有症状的颞下颌关节（TMJ）进行了摆线多层面断层扫描和带电视透视的低位关节造影。所有患者（16名女性，1名男性，年龄17至38岁）均患有明确的或疑似的类风湿性关节炎（成人型或青少年型）、强直性脊柱炎或银屑病关节炎。在14个TMJ中发现了骨质异常，主要是皮质侵蚀（11个关节），但也有髁突扁平（3个关节）。造影剂轮廓不规则、骨轮廓与造影剂之间的间隙、粘连盘和/或小关节腔的迹象表明15个关节存在滑膜增生/血管翳形成。其中6个（4个盘位置正常）显示关节腔之间有穿孔。在盘位置正常的关节中，穿孔似乎发生在中央部分。15个关节中有10个盘位置正常；其余5个有不可复性盘前移位。1个关节仅显示盘移位。大多数有骨质异常的关节（14个中的12个）显示出风湿性累及的关节造影征象。在6个无骨质异常的关节中的2个也观察到了此类征象，表明关节造影在风湿性疾病和TMJ问题患者的早期诊断中的价值。
