Rheumatoid Arthritis: Evaluation of Temporomandibular Joint Abnormalities with MR Imaging

It is well known that the temporomandibular joint (TMJ), as well as other joints, may be affected in patients with rheumatoid arthritis (RA). Conventional radiographic methods can be used in the assessment of bone damage but its usefulness is limited as the soft tissue involvement cannot be demonstrated. Many reports have shown the potential of magnetic resonance imaging in the evaluation of different TMJ components, all of which are often compromised in rheumatic disease; moreover MR imaging is superior for depicting advanced stages of rheumatic disease with various degrees of disc destruction. The purpose of this study was to evaluate the role of MR imaging in the assessment of RA. MR imaging of the TMJ was performed on 14 patients (11 women and 3 men, aged 36–79 years, mean 57.5) with diagnosed RA in stages 2 and 3 according to Steinbroker criteria. Both TMJs were evaluated in ten patients. A total of 24 TMJs were studied in this group of patients. Informed consent was obtained in each case. The goal of MR is not only to facilitate a diagnosis of rheumatoid arthritis, which may be done using laboratory and clinical parameters, but to assess the extent of the early soft-tissue and bone manifestations of the inflammatory process and to identify the stage of the disease.