MR alterations of the TMJ: The evalutation of the TMJ showed (figure 1): 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 edema: 8 unilaterally (Long RA) and 4 bilaterally (Early RA); 12 PT with monolateral reducible anterior dislocation (8 Long RA and 4 Early RA); 16 PT with non-reducible anterior dislocation (figure 4): 12 unilaterally (8 Long RA and 4 Early RA) and 4 bilaterally (Long RA); No PT with evidence of fracture of the disc or synovial pannus.
MR alterations of the AAJ: The evaluation of the AAJ by out method showed (Figure 5): 8 PT with synovial pannus (Long RA); 4 PT with erosions (Long RA),
4 PT with subluxation (figures 6,
7),
belonging to the Long RA group; No PT with joint effusion,
bone edema,
dislocation,
alar ligament rupture and medullary compression.
Of the 56 patients with TMJ symptomatology (40 Long RA and 16 Early RA),
in 8 patients (14%,
4 Long RA and 4 Early RA) no alterations of the joint were found with our method.
The remaining patients (48,
86%) showed the following alterations: erosions (16 PT,
33%),
thinning of the disc: (16 PT,
33%),
bone edema (12 PT,
25%),
flattening of the condyle (28 PT,
58%),
reducible dislocation (12 PT,
25%),
irreducible dislocation (16 PT,
33%).
They were symptomatic: 80% of the patients with erosions,
65% of the patients with thinning of the disk,
100% of the patients with bone edema,
87% of the patients with flattening of the condyle,
100% of the patients with dislocation (reducible and/or irreducible).
52 patients presented cervical pain and/or morning stiffness: only 2 patients (15%),
belonging of the Long RA group,
had synovial pannus (1 associated with subluxation and 1 associated with erosions).
Statistical correlations: Significantly correlated correlations were observed (Chi-square test and Fischer's exact test) between the alterations of the TMJ and the Long RA: between the autoantibody positivity and flattening the disk (p=0.018); between the positivity of acute phase reactants of inflammation and condylar bone edema (p = 0.018) and irreducible disk dislocation (p = 0.018).
The flattening of the disk is associated with TMJ symptomatology (p=0.043); the inflammation indices seem to be correlated,
at the limits of statistical significance (p=0.057),
with the anterior dislocation; TMJ symptomatology seems to be correlated,
to the limits of statistical significance,
with the reducible dislocation (p 0.057); the long AR is associated with condylar edema at the limits of statistical significance (p=0.06).
No correlations between Early RA and organic changes of the two joints were found.