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It is supposed to be difficult to diagnose rheumatoid arthritis in the temporomandibular joint due to the lack of diagnostic criteria for this region. Twenty-seven patients with rheumatoid arthritis accumulated in our department of out patients registration. These include seven initially involved cases on temporomandibular joint, six out of these seven suffered exclusively with the temporomandibular joint and the other is involved initially on the temporomandibular joint as well as the other joints, for example PIP, MCP, wrist joint, etc. Clinical research for rheumatoid arthritis in the temporomandibular joint was subjected to these twenty-seven patients, and the possibility of the diagnostic criteria was discussed.<BR>Clinical symptoms and radiographic findings are the most important aspects to diagnose this lesion. Crepitus, slight disturbance of mouth opening, pain on jaw functions, and temporomandibular joint stiffness are common clinical symptoms. Xerostomia and anemic complexion and/or color of gingiva are frequently found as the symptoms in the maxillofacial region except the temporomandibular joint area. On the radiographic findings of the temporomandibular joint, resorption on condylar head, fossa, and tubercle as well as faint and narrowed joint space are specific to this lesion. Heat accumulation on the temporomandibular joint area of bone scintigraphy are always recognized. As the referable items to this lesion, seropositive reaction of RF, high content of Gam.rnar Globulin, Ig-G, TTT, ZTT, CRP, and acceleration of BSG are generally found in rheumatoid arthritis. Swelling, pain, stiffness, deformity, and abnormalities on radiographic films of the other joints are also helpful to diagnose this lesion. Miscellaneously, predominanly adult women would visit our clinics with complaints related to the temporomandibular joint, i.e. pain in this region, and with xerostomia. The premonitory symptoms of rheumatoid arthritis could be also experienced with the initial involvement in the temporomandibular joint.<BR>This research succeeded to throw light upon the diagnostic items for rheumatoid arthritis in the temporomandibular joint. In the next step we are going to establish d. diagnostic criteria for this lesion, increasing the cases and calculating sensitivity, specificity, and accuracy of these items.
社団法人日本口腔外科学会の論文

顎関節リウマチの診断基準作成のための検討

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