Gynther G W, Holmlund A B, Reinholt F P, Lindblad S
Department of Oral and Maxillofacial Surgery, Huddinge University Hospital, Karolinska Institute, Stockholm, Sweden.
Int J Oral Maxillofac Surg. 1997 Feb;26(1):10-6. doi: 10.1016/s0901-5027(97)80838-7.
Twenty patients having generalized osteoarthritis (GOA) and symptomatic temporomandibular joints (TMJs) were compared with 22 patients having rheumatoid arthritis (RA) and TMJ symptoms, and also with an age-matched reference tissue material obtained at autopsy from 17 TMJs. Muscle tenderness was commoner in GOA. Arthroscopically, high frequencies of synovitis, degenerative changes, and fibrosis were observed in both groups, with more pronounced inflammatory and degenerative changes in RA patients, despite a shorter duration of TMJ symptoms. A correlation was noted between lateral joint tenderness and pronounced synovitis in RA patients. Histologic and immunohistochemical examinations added useful information to arthroscopy and showed similarly high frequencies of synovial inflammation in GOA and RA patients, differing clearly from those in the reference material. Connective-tissue degeneration was commoner in GOA patients. GOA and RA probably have different causes, but, interestingly, the tissue reaction was similar in the TMJs, although pronounced inflammatory and degenerative changes seemed to develop faster in RA.
将20例患有全身性骨关节炎（GOA）且有症状性颞下颌关节（TMJ）的患者与22例患有类风湿性关节炎（RA）且有TMJ症状的患者进行比较，并与从17个TMJ尸检中获取的年龄匹配的对照组织材料进行比较。肌肉压痛在GOA中更为常见。关节镜检查发现，两组均有高频的滑膜炎、退行性改变和纤维化，尽管RA患者TMJ症状持续时间较短，但其炎症和退行性改变更为明显。在RA患者中，外侧关节压痛与明显的滑膜炎之间存在相关性。组织学和免疫组织化学检查为关节镜检查提供了有用信息，并显示GOA和RA患者滑膜炎症的频率同样很高，这与对照材料明显不同。结缔组织退变在GOA患者中更为常见。GOA和RA可能有不同的病因，但有趣的是，尽管RA中明显的炎症和退行性改变似乎发展得更快，但TMJ中的组织反应相似。
