[TMJ and rheumatoid arthritis. Clinical study]

A clinical and epidemiological investigation was performed on a sample of randomly selected rheumatic patients in order to identify the prevalence of signs and symptoms of mandibular dysfunction. The collected data were used to calculate the Helkimo Anamnestic and Clinical Dysfunction Index. Signs of dysfunction were found in all the subjects (except one) and were significantly commoner in women than in men (p less than 0.01). The commonest clinical findings were: sound from the TMJ (crepitus or grating noise), impaired mandibular mobility, tenderness to palpation of the masticatory muscles. The comparison with a sample of a non-selected control-group was statistically significant (p less than 0.001). Contemporary radiographic examination demonstrated in many cases extreme resorbtion and remodelling of the condyle, increase of joint space and erosion of the fossa, otherwise reduced joint space and sclerosis, depending on superimposed degenerative arthritis (usually more painful). The survey showed a significant incidence of structural as well as functional involvement of TMJ in RA and suggested a more careful diagnostic and therapeutic approach.