Destructive psoriatic arthritis of the temporomandibular joint: a clinical case,an overview of the pathophysiology and its differential diagnoses |
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Authors: | Nicolas Patricio Skármeta DDS Luis Araneda DDS Cristobal Araya DDS |
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Institution: | 1. Faculty of Health Sciences, Occlusion and Orofacial Pain, School of Dental Medicine, Universidad San Sebastian, Santiago, Chile;2. Orofacial Pain and TMDs, OPH Dental, Santiago, Chile;3. Orofacial Pain and TMDs Hospital del Salvador, SSMO, Santiago, Chilenskarmetap@docente.uss.clhttps://orcid.org/0000-0002-3023-0777;5. Maxillofacial Radiology, Hospital del Salvador, SSMO, Santiago, Chile;6. Faculty of Health Sciences, Department of Maxillofacial Radiology, School of Dental Medicine, Universidad San Sebastian, Santiago, Chile;7. Faculty of Sciences, Maxillofacial Radiology, School of Dental Medicine, Universidad Mayor, Santiago, Chile;8. Faculty of Dentistry, Department of Maxillofacial Radiology, Universidad de Chile, Santiago, Chile;9. Faculty of Sciences, Oral Medicine and Pathology, School of Dental Medicine, Universidad Mayor, Santiago, Chile;10. Oral Medicine and Pathology, Instituto Nacional del Cancer, Santiago, Chile |
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Abstract: | AbstractBackground Clinical assessments and uniplanar images in temporomandibular disorders are not always entirely reliable. This predicament is especially important when clinicians need to determine the nature of temporomandibular joint disease, particularly when clinical features are not helpful in determining the diagnosis.Clinical presentation A 63-year-old female patient presented with mild pain in her right TMJ. During routine imaging exams, a destructive monoarticular arthritis was noticed, producing multiple erosions of the mandibular and temporal condyles. In addition, attrition of the ceiling of the glenoid fossa was observed, generating a communication with the endocranium. Only the presumptive biological behavior revealed on TMJ imaging and the appearance of the psoriatic plaques later during follow-up helped the authors to narrow the differential diagnosis.Conclusion The clinical case presented illustrates the difficulties in diagnosing an erosive, seronegative TMJ destruction, suggestive of a systemic arthritis. |
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Keywords: | TMJ temporomandibular joint diseases psoriatic arthritis TMJ arthritis erosive osteoarthritis |
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