A comparison of magnetic resonance imaging and cone beam computerized tomography in the evaluation of temporomandibular joint changes in rheumatoid arthritis patients

Abstract

Objectives: This study aimed to determine the features of temporomandibular joint involvement in rheumatoid arthritis patients and to examine the association of radiographic changes with RA duration by comparing the diagnostic efficacy of cone-beam computerized tomography to magnetic resonance imaging in identifying changes of TMJs.Methods: This case-control study was performed on 40 RA patients with 10 healthy adults (control cases). Clinical examination with CBCT and MRI as well as laboratory tests were done for participants. Independent and paired t-tests and correlation coefficient test were used for data analysis by SPSS program Results: The frequency of TMJ involvement using CBCT and MRI techniques were 82.5% and 87.5% in RA patients and were 50% and 30% in control cases. The most frequently observed clinical symptom was facial pain (25%), and the slightest symptom was clicking (2.5%) during mouth opening. The commonest change in CBCT of RA patients was condylar head erosion (67.5%), and the less common change was articular eminence erosion (7.5%). The commonest changes in MRI of RA patients were an osseous change of condylar head (80%), and the minor change was effusion (10%), while in controls were an osseous change of condylar head (30%) and condylar head flattening (10%). There was a positive correlation between ESR, RF, and Anti-CCP and osseous TMJ changes, while CRP shows a negative correlation. Conclusions: Osseous changes occur in TMJs of RA patients with no/mild symptoms, MRI can be used as efficient imaging modality for detecting changes in TMJ, and elevated ESR, RF and Anti-CCP may indicate the presence of osseous changes in RA patients.