Temporomandibular joint involvement in generalized osteoarthritis and rheumatoid arthritis: a clinical, arthroscopic, histologic, and immunohistochemical study

• Published in: International journal of oral and maxillofacial surgery Vol. 26; no. 1; pp. 10 - 16
• Main Authors: Gynther, Göran W., Holmlund, Anders B., Reinholt, Finn P., Lindblad, Staffan
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier Ltd 01.02.1997; Elsevier
• Subjects: Adolescent; Adult; Aged; Arthritis, Rheumatoid - pathology; Arthritis, Rheumatoid - physiopathology; Arthroscopy; Biological and medical sciences; Cartilage, Articular - pathology; Case-Control Studies; clinical findings; Connective Tissue - pathology; Dentistry; Facial Pain - physiopathology; Female; Fibrosis; generalized osteoarthritis; Humans; Immunohistochemistry; Macrophages - pathology; Male; Masticatory Muscles - physiopathology; Medical sciences; Medicin och hälsovetenskap; Middle Aged; Non tumoral diseases; Osteoarthritis - pathology; Osteoarthritis - physiopathology; Otorhinolaryngology. Stomatology; Proliferating Cell Nuclear Antigen - analysis; rheumatoid arthritis; Synovial Membrane - pathology; Synovitis - pathology; T-Lymphocytes - pathology; temporomandibular joint; Temporomandibular Joint Disc - pathology; Temporomandibular Joint Disorders - pathology; Temporomandibular Joint Disorders - physiopathology; Upper respiratory tract, upper alimentary tract, paranasal sinuses, salivary glands: diseases, semeiology; clinical findings; arthroscopy; immunohistochemistry; temporomandibular joint; rheumatoid arthritis; generalized osteoarthritis; Human; Immunohistochemistry; Immunopathology; Stomatology; Diseases of the osteoarticular system; Temporomandibular joint; Autoimmune disease; Inflammatory joint disease; Generalized; Pathology; Symptomatology; Chronic; Arthroscopy; Rheumatoid arthritis; Arthropathy; Degenerative disease; Endoscopy; Diagnosis; Osteoarthritis; Comparative study; Maxillary disease
• ISSN: 0901-5027; 1399-0020
• DOI: 10.1016/S0901-5027(97)80838-7

Twenty patients having generalized osteoarthritis (GOA) and symptomatic temporomandibular joints (TMJs) were compared with 22 patients having rheumatoid arthritis (RA) and TMJ symptoms, and also with an age-matched reference tissue material obtained at autopsy from 17 TMJs. Muscle tenderness was commoner in GOA. Arthroscopically, high frequencies of synovitis, degenerative changes, and fibrosis were observed in both groups, with more pronounced inflammatory and degenerative changes in RA patients, despite a shorter duration of TMJ symptoms. A correlation was noted between lateral joint tenderness and pronounced synovitis in RA patients. Histologic and immunohistochemical examinations added useful information to arthroscopy and showed similarly high frequencies of synovial inflammation in GOA and RA patients, differing clearly from those in the reference material. Connective-tissue degeneration was commoner in GOA patients. GOA and RA probably have different causes, but, interestingly, the tissue reaction was similar in the TMJs, although pronounced inflammatory and degenerative changes seemed to develop faster in RA.