Destructive psoriatic arthritis of the temporomandibular joint: a clinical case, an overview of the pathophysiology and its differential diagnoses

Clinical assessments and uniplanar images in temporomandibular disorders are not always entirely reliable. This predicament is especially important when clinicians need to determine the nature of temporomandibular joint disease, particularly when clinical features are not helpful in determining the...

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Bibliographic Details
Published inCranio Vol. 38; no. 3; p. 201
Main Authors Skármeta, DDS, Nicolas Patricio, Araneda, DDS, Luis, Araya, DDS, Cristobal
Format Journal Article
LanguageEnglish
Published England 03.05.2020
Subjects
Arthritis, Psoriatic
Diagnosis, Differential
Female
Humans
Mandible
Middle Aged
Temporomandibular Joint
Temporomandibular Joint Disorders
TMJ
erosive osteoarthritis
psoriatic arthritis
temporomandibular joint diseases
TMJ arthritis
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Summary:Clinical assessments and uniplanar images in temporomandibular disorders are not always entirely reliable. This predicament is especially important when clinicians need to determine the nature of temporomandibular joint disease, particularly when clinical features are not helpful in determining the diagnosis. A 63-year-old female patient presented with mild pain in her right TMJ. During routine imaging exams, a destructive monoarticular arthritis was noticed, producing multiple erosions of the mandibular and temporal condyles. In addition, attrition of the ceiling of the glenoid fossa was observed, generating a communication with the endocranium. Only the presumptive biological behavior revealed on TMJ imaging and the appearance of the psoriatic plaques later during follow-up helped the authors to narrow the differential diagnosis. The clinical case presented illustrates the difficulties in diagnosing an erosive, seronegative TMJ destruction, suggestive of a systemic arthritis.
ISSN:2151-0903
DOI:10.1080/08869634.2018.1484575