Читать книгу Temporomandibular Disorders - Robin J. M. Gray - Страница 52

Uncommon conditions affecting the TMJ include rheumatoid arthritis and psoriatic arthritis. Pathologically there is a thickened synovial membrane and joint effusion. There is cartilage destruction and cortical erosion and, in advanced stages of both diseases, severe bone destruction or proliferation may occur (Figure 2.19); on very rare occasions fibrous or bony ankylosis can be the end‐point. If there is severe osteolysis, destruction of a condylar head can occur and an anterior open bite may result. It is not normal for a patient to present with rheumatoid or psoriatic arthritis in the TMJ as the first symptom. Usually diagnosis of the systemic disease will have preceded this late involvement.

Figure 2.19 (a) Psoriasis skin condition; (b) excised condyle of a patient with psoriatic arthritis.

(M. Ziad Al‐Ani, Robin J.M. Gray.)