クローン病患者に見られた顎関節滑膜炎の一例

概要

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We report a case of bilateral temporomandibular joint (TMJ) synovitis in a patient with Crohn's disease. The patient was an eighteen year old male, who had been diagnosed with Crohn's disease in February 1992 at Yamagata University Medical Hospital. The patient complained of jaw opening pain of the bilateral TMJ, and was referred to the Department of Oral and Maxillofacial Surgery of the Hospital. The magnetic resonance images demonstrated severe joint effusion in the upper and lower compartments of the bilateral TMJ. The synovial fluids, aspirated with the direct method from the upper and lower cavities of the right TMJ, were analyzed biochemically on glycosaminoglycans, cytokines, and oxidation products of nitric oxide. These results showed a higher concentration of IL-1β and TNF-α in the synovial fluid of the right TMJ in this patient. This report is the first to demonstrate a higher concentration of IL-1β and TNF-α in the synovial fluid of the TMJ in patients with Crohn's disease. This result suggests that an initial treatment method for TMJ synovitis with Crohn's disease is to irrigate by a large volume of saline, TMJ irrigation therapy.
北海道医療大学の論文