Ann Rheum Dis 1997;56:103-107 ( February )
Extended reports
Temporomandibular joint osseous morphology in a consecutive
sample of ankylosing spondylitis patients
Cesar Ramos-Remus,a
Paul Major,b
Amparo Gomez-Vargas,a
Grace Petrikowski,b
Abel Hernandez-Chavez,a
Enrique Gonzalez-Marin,a
Anthony S Russellb
a Department of Rheumatology, Hospital
de Especialidades del Centro Medico Nacional de Occidente, IMSS
Guadalajara, Jal, Mexico , b TMD Investigation Unit, Department of Oral Health
Sciences, University of Alberta. Edmonton, AB, Canada
Correspondence to: Dr Cesar Ramos-Remus,
Departamento de Reumatología, Piso 12, Hospital de Especialidades,
Belisario Domínguez #1000, SL, Guadalajara, Jal 44320 México.
Accepted for publication 22 November 1996
OBJECTIVE
To evaluate temporomandibular joint
(TMJ) osseous morphology in a consecutive sample of Mexican patients
with ankylosing spondylitis.
METHODSConsecutive patients with a diagnosis of
ankylosing spondylitis who attended two secondary care outpatient
rheumatology clinics were included in the study. Patients had a
rheumatological assessment using a structured questionnaire and
examination. Recorded variables included demographic data, disease
characteristics, TMJ symptoms, and axial mobility measurements.
Hypocycloidal tomography of the TMJ was obtained on all subjects.
Radiographic variables included condyle position, superior joint space,
range of movement, condylar osseous changes, and temporal osseous
changes. Patients also underwent standard cervical spine radiography. A
control group of normal people without either TMJ symptoms or systemic
rheumatic disease was obtained.
RESULTS65 subjects were studied (65 right sided
and 63 left sided tomograms). The control group consisted of 22 individuals. Both groups were similar in age [33 (SD 11)
v 34 (9) years, P = 0.8]. Patients with ankylosing
spondylitis had more variability in TMJ mobility than controls (P < 0.05) and showed increased frequency of condylar erosions (P < 0.01),
flattening (P < 0.01), sclerosis (P < 0.01), and temporal flattening
(P < 0.01). Condylar erosions were associated with longer duration of
ankylosing spondylitis (P < 0.05), neck complaints (P < 0.05), and
atlantoaxial subluxation (P < 0.05).
CONCLUSIONSTMJ involvement is frequent in this
population of patients with ankylosing spondylitis and is associated
with variables that suggest more severe disease.
© 1997 by Annals of the Rheumatic Diseases
