Background Psoriatic arthritis (PA) is a chronic progressing spinal and articular disease associated with psoriasis resulting in development of erosive arthritis, ankylosing of joints and intraarticular osteolysis. It is included into seronegative arthritides and has clinical-radiological peculiarities common for this group of diseases.
Objectives To find out the prevalence and character of temporo-mandibular damage (TMD) during PA and determine the correlation of such damage with other manifestations of this disease.
Methods 76 PA pts were examined. Median age of pts was 36.7 ± 5.6 years and median disease duration 3.4 ± 0.8 years. Radiological stage of damage (except TMD) in 42.1% of pts was II according Steinbrocker and in 39.5% – III. All pts had clinical examination of TMD with detailing of volume of mobility, possible dislocation of articular disk, determining of mandibular deviation during mouth opening, cephalometric studies. TMD radiography by method of Schuller and Parma, orthopantomorphography, stratal magnetic-resonance computer tomography.
Results TMD in PA debut was found in 25 (32.9%) of pts and occupied the 6th place by frequency among other articular damages. In 60% of cases arthralgia was noticed. In some cases there were stable arthralgias and speedy decrease of articular mobility of this localization. More often we found bilateral damage as compared with unilateral. There were cases of isolated TMD in PA debut. In the developed stage of the disease almost all pts (67 out of 76, or 88.1%) demonstrated painfulness during palpation of periarticular muscles. Limitation of mandibular excursion of III and IV stage was found in 18 pts. TMD deviations were noticed prevalently in unilateral damage of them. No occlusion pathology or deformation of face skeleton was found. According to TMD radiography, aside from osteoporosis and narrowing of articular space, 27 pts demonstrated erosion of joints surfaces and in 6 cases osteolysis of the head of the mandible. In the majority of cases the stage of TMD correlated to radiological PA stage as a whole.
Conclusion TMD is a frequent PA clinical manifestation. The frequency and character of such damage are closely related with the activity of inflammatory processes, arthritis prevalence and stage of its development.
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