Magnetic resonance imaging and clinical assessment of temporomandibular joint pathology in ankylosing spondylitis

Objective, To evaluate temporomandibular joint (TMJ) articular disc positio n and osseous degenerative changes using magnetic resonance imaging (MRI) a s well as clinical symptoms of temporomandibular disorders in patients with ankylosing spondylitis (AS). Methods. A sample of 43 patients with AS (38 males, age 45.9 +/- 10.7 years ) and 16 controls (all male, age 41.3 +/- 6.3 years) were studied. All subj ects completed a self-administered questionnaire and underwent clinical exa mination and MRI sun ey. Recorded variables included disease characteristic s, subjective neck and TMJ disorder symptoms, and axial mobility measuremen ts. MRI variables included TMI disc position and severity of osseous degene rative change. Results, TMJ disorder symptoms of headache duration and frequency, TMJ pain duration and frequency, and painful jaw movement were more frequent in pat ients with AS (p < 0.05). Significant differences were also observed in MRI indices for disc displacement (AS, 0.89; controls, 0.36; p 0.005) and dege nerative changes (AS, 0.55; controls, 0.06; p = 0.01). A total of 50 (62%) joints in the AS group had disc displacement compared to Ii (34%) joints in the controls, a total of 16 (20%) joints in the AS group had degenerative change compared to 2 (6%) joints in the controls. Conclusion. TMJ internal derangement, degenerative changes, and subjective pain complaints are frequent in patients with AS. Physicians should be awar e of potential TMJ involvement in these patients, which may require specifi c assessment and therapy.