High-resolution computed tomography in the analysis of temporomandibular joint in adult patients with rheumatoid arthritis

Abstract

A quantitative and qualitati- ve analysis of morphological and morphometric variations of the Temporomandibular Joint in adult patients with Rheumatoid Arthritis (RA), in different ages, was made by means of computed tomogra- phy (CT) scans with Multiplanar (MPR) and Tridimensional (3RD) Reconstructions. The TMJs of 22 adult subjects (20 males and 2 females), aging from 43 to 69 years, were analysed by CT, with MPR and R3D, by means of mea- surement and quantification of the anatomic dimensions of the head of the articular process of the jaw, in different orthogonal axes and the description of structural chan- ges of the bone components of the TMJ. Statistical tests (Student’s “t” test, Pearson Correlation Analysis, One-way Analysis of Variance – Anova) and comparison of mean percentage were applied in order to verify the differences, correla- tions and range of variation among each of the variables. The largest dimensions registered in different orthogonal views and directions did not show statistically signifi- cant difference (p < 0.01) between each other or correlation with age, time of pathology diagnosis or treatment time; showing strong positive correlation between va- lues of the right and left sides and between the axial and corrected coronal views (in latero-medial direction), and also the axial with corrected sagital view ( in antero- posterior direction), showing the accuracy of current technology of CT with MPR in the diagnosis by image of the TMJ. The structural changes with the highest percen- tual values in RA-affected TMJs, in this sample, were subcondral cysts and flattening in MPR, and osteophytes and flatttening of the head of the articular process in 3RD. The election views for TMJ structural analysis in MPR are the corrected coronal and sagital, and in 3RD, the corrected sagital and coronal ones, respectively. Key words: temporomandi- bular joint, rheumatoid arthritis, computed tomography, multipla- nar reconstruction, tridimensional reconstruction