Background The inflammatory involvement of temporomandibular joint (TMJ) in rheumatic diseases may induce the damage of the TMJ provoking a severe impairment of mouth opening and affecting patient’s quality of life. TMJ may be also involved in systemic sclerosis (SSc).
Objectives The aim of the present investigation was to evaluate the usefulness of US imaging for the detection of disc displacement, condylar alterations and intrarticular effusion in SSc patients (pts) compared with magnetic resonance imaging (MRI).
Methods 35 SSc patients (females with mean age 65.9 years) with TMJ involvement were consecutively examined. US examination was performed on both TMJ, in static and dynamic phases, by means of My Lab70 US 7-18 MHz (Esaote, Genoa, Italy). The probe was placed along the axis of the mandibular branch. The following TMJ characteristics were evaluated in each joint: 1) joint space; 2) presence of joint effusion; 3) condylar profile; 4) position of the articular disc at open and closed mouth. In all pts was performed MRI on both TMJ.
Results All SSc patients had reduced mouth opening with monolateral or bilateral TMJ pain. Not correlation with disease duration was found.
In the patients joint effusion was depicted by a thin line or area of high signal intensity within the joint space. It was detected in 6/35 SSc pts (17.1%). Condilar alterations were detected by MRI in 19/35 SSc pts (54,2%). MRI revealed also disc displacement in 10/35 SSc pts (28,5%). In 7 SSc pts erosions were present.
In 7/35 SSc pts (20%) US showed joint effusion. Condilar alterations were observed in 21/35 SSc pts (60 %). Disc displacement was evident in 12/35 SSc pts (34,2%). Erosions were detected in 9 SSc patients.
The concordance between US and MRI was evaluated. For joint effusion, concordance was 83%. In US assessment of disc displacement, a concordance with MRI was 82.8%. A concordance for condilar alterations was detected 77%.
Conclusions Our data show that the pathological changes of TMJ may be detected by US examination in SSc pts.
It is important to note that pain in SSc pts is not usually related to the occurrence of joint effusion but more often to disc displacement or remodelling of the condyle and the presence of condylar alterations in SSc is an interesting finding observed by US.
Disclosure of Interest None Declared