Rheumatoid arthritis of TMJ--a diagnostic dilemma?

Area of Science:

• Rheumatology
• Orthodontics
• Radiology

Background:

• Rheumatoid arthritis (RA) is a chronic systemic autoimmune disease primarily affecting connective tissues, particularly joints.
• The temporomandibular joint (TMJ) can be affected by RA, though typically as a later manifestation.
• Systemic disorders frequently involve the TMJ, presenting diagnostic challenges when they manifest atypically.

Observation:

• A case report details a patient undergoing orthodontic treatment who developed unilateral condylar changes.
• The patient's serum tested positive for rheumatoid factor, a key indicator for RA.
• This presentation of TMJ involvement in RA was atypical, occurring during orthodontic treatment.

Findings:

• The case illustrates unilateral condylar changes in the TMJ associated with rheumatoid arthritis.
• Rheumatoid factor positivity confirmed the systemic autoimmune nature of the condition.
• Atypical TMJ manifestation in RA can mimic other conditions, complicating diagnosis.

Implications:

• Early recognition of atypical TMJ involvement in RA is crucial for timely diagnosis and management.
• Understanding diverse presentations of TMJ disorders is essential for clinicians, especially during orthodontic interventions.
• This case underscores the importance of considering systemic diseases when evaluating condylar erosions.