TEMPOROMANDIBULAR-JOINT OSSEOUS MORPHOLOGY IN A CONSECUTIVE SAMPLE OFANKYLOSING-SPONDYLITIS PATIENTS

Objective-To evaluate temporomandibular joint (TMJ) osseous morphology in a consecutive sample of Mexican patients with ankylosing spondylit is. Methods-Consecutive patients with a diagnosis of ankylosing spondy litis 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 i ncluded demographic data, disease characteristics, TMJ symptoms, and a xial mobility measurements. Hypocycloidal tomography of the TMJ was ob tained on all subjects. Radiographic variables included condyle positi on, superior joint space, range of movement, condylar osseous changes, and temporal osseous changes. Patients also underwent standard cervic al spine radiography. A control group of normal people without either TMJ symptoms or systemic rheumatic disease was obtained. Results-65 su bjects 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 sp ondylitis had more variability in TMJ mobility than controls (P < 0.05 ) and showed increased frequency of condylar erosions (P < 0.01), flat tening (P < 0.01), sclerosis (P < 0.01), and temporal flattening (P < 0.01). Condylar erosions were associated with longer duration of ankyl osing spondylitis (P < 0.05), neck complaints (P < 0.05), and atlantoa xial subluxation (P < 0.05). Conclusions-TMJ involvement is frequent i n this population of patients with ankylosing spondylitis and is assoc iated with variables that suggest more severe disease.