Aims and objectives
Rheumatoid Arthritis (RA) is a common systemic,
chronic autoimmune disease characterized by an uncontrolled proliferation of synovial tissue and multisystem comorbidities,
associated with progressive disability,
early mortality and significant socio-economic impact [1-4].
The temporomandibular joint (TMJ) is involved in more than 50% of cases,
often in a symmetrical way,
with an evolution characterized by thinning of the disc,
synovial cloth formation,
erosion of the condyle,
reducible and/or irreducible dislocation and destruction of the periarticular soft...
Methods and materials
Patient population: Eighty adult patients (mean age=55.65 years,
64 females and 16 males) were enrolled with RA diagnosis according to the criteria ACR/EULAR 2010  and were divided into 2 groups: Early group (RA with onset <1 year) consisting of 32 patients,
diagnosed between 2 months and 1 year (average: 9.75 months) and Long Group (RA with onset> 1 year) consisting of 48 patients,
diagnosed between 2 years and 49 years (average: 13 years).
In both groups we evaluated the autoantibodies typical of RA,
MR alterations of the TMJ: The evalutation of the TMJ showed (figure1): 20 PT with erosions of the condyle (figures 2,
3): 12 unilaterally (Long RA) and 8 bilaterally (Long RA); 24 PT with thinning of the disk (figure 4): 12 unilaterally (Long RA) and 12 bilaterally (Long RA); 32 PT with a flattening of the condyle (figure 4): 20 unilaterally (12 Long RA and 8 Early RA) and 12 bilaterally (Long RA); 4 PT with joint effusion (Long RA); 12 PT with condylar bone...
the presence of symptomatology,
even more if associated with positive autoantibodies and inflammatory indices,
is related to organic alterations evident with our method (open gantry 0.28 T MRI scan without contrast with dedicated coils),
such as the flattening of the disc,
the erosions of the mandibular condyle and the altered articular relationships.
These alterations are very important from the clinical and prognostic point of view,
especially in relation to the quality of life of patients with RA,
and are also the subject of...
Departement of Advanced Biomedical Sciences,
University of Naples "Federico II",
de Falco 26,
81100 Caserta (CE),
Departement of Radiology and Interventional Radiology,
Miulli" Regional General Hospital,
Acquaviva delle Fonti (BA),
Departement of Bioimaging and Radiological Sciences,
Institute of Radiology,
Gemelli" Hospital- Catholic Universityof the Sacred Heart,
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The Pathogenesis of Rheumatoid Arthritis.
New England Journal Medicine 2011 Dec; 365:2205-19.
2) Kumar V,
Robbins e Cotran.
Le basi patologiche delle malattie.
3) Menard HA,
Insight into rheumatoid arthritis derived from the SA Immune system.
Arthrits Res 2000.
4) Pincus T,
What is the natural history of rheumatoid arthritis? Rheum Dis Clin North Am.
1993 Feb; 19(1): 123-51.