Abrahamsson A K, Kristensen M, Arvidsson L Z, Kvien T K, Larheim T A, Haugen I K
Department of Maxillofacial Radiology, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Oslo, Norway.
Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway.
Osteoarthritis Cartilage. 2017 May;25(5):654-657. doi: 10.1016/j.joca.2016.12.028. Epub 2017 Jan 5.
The prevalence of osteoarthritis (OA) in the temporomandibular joints (TMJs) in hand OA patients is largely unknown. Our aims were to explore (1) The frequency of TMJ-related symptoms and clinical findings; (2) The TMJ OA frequency defined by cone beam computed tomography (CBCT); and (3) The relationship between TMJ-related symptoms/clinical findings and CBCT-defined TMJ OA, in a hand OA cohort.
We calculated the frequencies of TMJ-related symptoms, clinical findings and diagnosis of TMJ OA by CBCT and clinical examination in 54 patients from the Oslo hand OA cohort (88% women, mean (range) age 71 (61-83) years). Participants with and without CBCT-defined TMJ OA were compared for differences in proportions (95% confidence interval (CI)) of symptoms and clinical findings. Sensitivity and specificity of the clinical TMJ OA diagnosis were calculated using CBCT as reference.
Self-reported symptoms and clinical findings were found in 24 (44%) and 50 (93%) individuals (93%), respectively, whereas 7 (13%) had sought healthcare. Individuals with CBCT-defined TMJ OA (n = 36, 67%) reported statistically significantly more pain at mouth opening (22%, 95% CI 4-40%), clicking (33%, 95% CI 14-52%) and crepitus (25%, 95% CI 4-46%). By clinical examination, only crepitus was more common in TMJ OA (33%, 95% CI 29-77%). Clinical diagnosis demonstrated low sensitivity (0.42) and high specificity (0.93).
CBCT-defined TMJ OA was common in hand OA patients, suggesting that TMJ OA may be part of generalized OA. Few had sought healthcare, despite high burden of TMJ-related symptoms/findings. Clinical examination underestimated TMJ OA frequency.
手部骨关节炎（OA）患者颞下颌关节（TMJ）骨关节炎的患病率很大程度上未知。我们的目的是探讨：（1）TMJ相关症状和临床发现的频率；（2）锥形束计算机断层扫描（CBCT）定义的TMJ OA频率；以及（3）手部OA队列中TMJ相关症状/临床发现与CBCT定义的TMJ OA之间的关系。
我们通过CBCT和临床检查计算了来自奥斯陆手部OA队列的54例患者（88%为女性，平均（范围）年龄71（61 - 83）岁）中TMJ相关症状、临床发现和TMJ OA诊断的频率。比较有和没有CBCT定义的TMJ OA的参与者在症状和临床发现比例（95%置信区间（CI））上的差异。以CBCT为参考计算临床TMJ OA诊断的敏感性和特异性。
分别有24例（44%）和50例（93%）个体有自我报告的症状和临床发现，而7例（13%）曾寻求医疗保健。CBCT定义的TMJ OA患者（n = 36，67%）在张口时疼痛（22%，95% CI 4 - 40%）、弹响（33%，95% CI 14 - 52%）和摩擦音（25%，95% CI 4 - 46%）的报告在统计学上显著更多。通过临床检查，仅摩擦音在TMJ OA中更常见（33%，95% CI 29 - 77%）。临床诊断显示敏感性低（0.42）和特异性高（0.93）。
CBCT定义的TMJ OA在手部OA患者中很常见，表明TMJ OA可能是全身性OA的一部分。尽管TMJ相关症状/发现负担高，但很少有人寻求医疗保健。临床检查低估了TMJ OA的频率。
