Kojima Ikuho, Nogami Shinnosuke, Hitachi Shin, Shimada Yusuke, Ezoe Yushi, Yokoyama-Sato Yuka, Iikubo Masahiro
Department of Oral and Maxillofacial Radiology, Tohoku University Hospital, Sendai, Japan.
Department of Dental Informatics and Radiology, Tohoku University Graduate School of Dentistry, Sendai, Japan.
Imaging Sci Dent. 2024 Jun;54(2):201-206. doi: 10.5624/isd.20230243. Epub 2024 May 7.
This report showed a case of temporomandibular joint (TMJ) ankylosis suspected to be associated with ankylosing spondylitis based on the observation of bony ankylosis of the cervical spine on computed tomography (CT) images. A 53-year-old man presented with a chief complaint of difficulty in opening his mouth. His medical history indicated that in his 20s, he became aware of the difficulty in moving his neck. CT revealed marked osteoarthritic changes in the right mandibular condyle, suggesting fibrotic TMJ ankylosis. In addition, bony ankylosis of the cervical vertebral body and facet joints from the axis (C2) to C5 in continuity was observed. CT of the entire spine also showed bony deformity of the sacroiliac joints and bony ankylosis. Based on these findings, ankylosing spondylitis was suspected. The possibility of an ankylosing spondylitis complication should be considered in cases of TMJ ankylosis if bony ankylosis of the cervical spine is observed.
本报告展示了一例颞下颌关节（TMJ）强直病例，基于计算机断层扫描（CT）图像上观察到的颈椎骨融合，怀疑其与强直性脊柱炎有关。一名53岁男性，主要诉求为张口困难。他的病史显示，在20多岁时，他就意识到颈部活动困难。CT显示右侧下颌髁突有明显的骨关节炎改变，提示纤维性TMJ强直。此外，观察到从枢椎（C2）到C5的颈椎椎体和小关节连续出现骨融合。全脊柱CT还显示骶髂关节骨质畸形和骨融合。基于这些发现，怀疑为强直性脊柱炎。如果观察到颈椎骨融合，在TMJ强直病例中应考虑强直性脊柱炎并发症的可能性。
