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تقييم اصابة المفصل الفكي الصدغي عند مرضى الصدفية باستعمال التصوير المقطعي المحوسب للكشف عن التغيرات المفصلية == Evaluation of The Involvement of The Tempromandibular Joint In Patients With Psoriasis Using Computed Tomography For Detection of Psoriatic Arthritis Changes
Author name:
منتهى فوزي صالح
Supervisor name:
هاجر ابراهيم عبد الله
General topic:
Dentistry
Specific topic:
Oral and Maxillofacial Surgery
Degree:
Master
University:
Mustansiriyah University
Language:
English
University location:
Baghdad
First pages:
20T400 - p.pdf
Abstract:
اضطرابات المفصل الفكي الصدغي تشير الى مصطلح مركب يحتوي على عدة حالات تتضمن المفصل الصدغي,التركيبات المحيطة او كلاهما.اضطرابات المفصل الفكي الصدغي هي مجموعة اعراض معقدة اكثر من كونها حالة معينة واحدة, ويعتقد انها تنتج من عدة عوامل مثل : العوامل الجينية, ال | Tempromandibular disorders is a collective term, embracing several clinical problems involving the muscles of mastication, temporomandibular joint (TMJ), or both.Tempromandibular disorders is a symptom complex rather than a single condition, and it is thought to be caused by multiple factors like : genetic, developmental and metabolic.TMDs form a cluster of related disorders with common symptoms which include localized pain, limited or asymmetric movement, and clicks or grating on opening.Psoriatic arthritis is a chronic inflammatory arthropathy that affects patients with psoriasis. Psoriatic arthritis is most commonly a seronegative oligoarthritis found in patients with psoriasis and therefore occurs more commonly in patients with tissue type HLA - B27. The clinical findings for Tempromandibular Psoriatic arthritis are pain, tenderness, limitation of movement , joint stiffness, clicking as the jaw is opened or closed, difficulty in opening the mouth, locking of the jaw,and crepitations. These findings are essentially the same as for Tempromandibular disorders.• Objective of the study : • To determine the extent of tempromandibular joint involvement in patients with psoriatic arthritis.• To correlate between clinical findings and radiographic finding.Materials and method : In this study 98 patients were selected ,50 male and 48 female, their age ranged between(18 - 68)years. They were collected at Al - yarmook teaching hospital/department of dermatology during the period from ( NOV 2014 - May 2015).They were diagnosed as having psoriatic arthritis by a dermatologist according to (Moll and Wright diagnostic criteria 1973).These patients were sent to rheumatoid factor test RF to exclude the presence of rheumatoid arthritic disease, then the patients were exposed to CT scanning for the Tempromandibular joint in Al - Yarmook teaching hospital for screening the involvement of TMJ with psoriatic arthritis by the presence of any radiographic changes such as erosion, flattening,osteophyte and sclerosis in the condylar head.Results : The result of the study showed that the mean age of psoriatic arthritic patients in TMJ was (44.2) years, and the female percentage was (48.4%) and the male was (51.6%). Psoriatic arthritis in TMJ showed high significance in the unilateral side symptoms (100%) it was significant in patients with positive family history (54.8%), and non significant in the right/left ratio (41.9%). Oligo type was found in twenty six patients (83.9%) with significant p - value. Clinically, all symptoms including clicking, tenderness and tempromadibular joint pain were highly significant, limitation showed (54.8%), TMJ pain showed (64.5%) and tenderness showed (54.8%).Radiologically : CT scan showed sensitivity for erosion in TMJ (54.8%), for osteophyte (32.3%), for condylar flattening (16.1%) and for sclerosis (9.7%) while specificity for all were (100%). Association between clinical symptoms and radiological changes showed non significant correlation. Conclusions : Psoriatic arthritis of TMJ has been found oftenly unilateral (oligo type). Female/ male ratio is about 1 : 1. nearly 50% of patients were having limitation in mouth opening. Most of the patients were having positive family history.The development of psoriatic arthritis in TMJ is related to the duration of the disease. Plaque psoriasis is the most associated type with the psoriatic arthritis in TMJ. Most of patients with psoriatic arthritis show psoriatic nail changes. The most radiographic findings found in patients with psoritic arthritis was erosion in the condylar head. There is association between clinical and radiologic findings for psoriatic arthritis in TMJ.
