Arthritis of the temporomandibular joint - damage to the joints of the face of an inflammatory nature. Inflammatory processes can be divided into several types, which can have a chronic or acute stage.
As a result of this, hemorrhage in the joint, cracks and bone fractures can occur with the subsequent development of the inflammatory process. Often, such a disorder occurs at a young age.
Joint anatomy
The maxillary joint is responsible for the movement of the lower jaw in different directions. It consists of the hollow of the temporal bone, the articular head of the lower jaw, as well as the ligaments and muscles that help hold the joint in position. It consists of two separate blocks that perform movements simultaneously.
The unique cartilage located inside the joint provides the possibility of its movement in three directions, suggesting:
- opening and closing the mouth;
- chewing movements;
- jaw movement back and forth.
Blood circulation is carried out from the carotid artery. In addition, trigeminal nerves are located nearby, therefore, with arthritis of the temporomandibular joint, a person experiences strong pain.
Disease feature
ICD arthritis of the temporomandibular joint is an inflammatory process of an infectious or non-infectious nature. Inflammation can cover the entire joint or be limited only to the periarticular tissues.
Given the cause of the disease, the infectious type of arthritis may be specific or non-specific. In addition, there may be arthritis of a non-infectious nature, in particular, such as:
- rheumatoid;
- traumatic;
- reactive.
With the acute stage of arthritis, there may be periods of purulent or serous inflammation of the joint tissue.
Infectious Arthritis
According to the ICD 10, arthritis of the temporomandibular joint of an infectious nature refers to the inflammatory processes that occur due to the occurrence of infectious diseases. The ailment code is K07.6. Infectious arthritis is divided into reactive and acute bacterial. The acute bacterial type of the disease is provoked by a specific and nonspecific infection. Specific species, in turn, are divided into:
- gonorrheal;
- tuberculous
- actinomycotic;
- syphilitic.
The disease begins very acutely, mainly localizing in only one of the joints. Among the main signs of the course of the disease, one can highlight the presence of painful sensations, which intensify with the movement of the jaw. The pain gives in the temples, ear, neck.
Reactive arthritis
Reactive arthritis of the temporomandibular joint belongs to the group of inflammatory diseases in which a connection with the course of a certain infection is very clearly traced. It is worth noting that the causative agent of the disease and other infection in the affected joint are absent. Among the main sources of joint damage, it is necessary to distinguish such as:
- chlamydial;
- streptococcal;
- dysenteric;
- adenovirus;
- nasopharyngeal.
The clinical manifestations of the course of the disease are very acute and significant soreness is noted after eliminating the root cause of the disease. With the course of the infectious process, a relapse of the reactive process in the joints is possible.
Nonspecific arthritis
Nonspecific arthritis may be rheumatoid or rheumatic. Rheumatism refers to infectious and allergic diseases and is characterized by damage to the connective tissue with localization of pathology in the heart. It occurs a few weeks after the infection of the upper respiratory tract.
Inflammation proceeds with periodic exacerbations, accompanied by a low temperature, soreness. The reaction from the periarticular tissues is slightly expressed.
Rheumatoid arthritis of the temporomandibular joint refers to chronic diseases of the connective tissue with lesions of the synovial joints in the form of polyarthritis. The disease begins with a symmetrical lesion of the small joints of the feet and hands, constantly progresses, and also gradually affects all joints.
Specific arthritis
Specific arthritis of the temporomandibular joint may be tuberculous or actinomycotic. The course of tuberculous arthritis in the joints is different in duration. It is accompanied by moderate soreness, as well as limited mobility of the joints. Fistulas on the skin of the face and ear canal are possible.
During the diagnosis, mycobacterium tuberculosis is found in the joint fluid. Treatment in this case is complex and involves the use of conservative and surgical techniques.
Actinomycotic arthroso-arthritis of the temporomandibular joint proceeds with the involvement of the articular capsule in the pathological process that occurs in the periarticular soft tissues. The clinical manifestation is characterized by the presence of seals, cyanosis of the skin, periodic exacerbation with the formation of fistulas, and with an abscess, pus formation is observed. With the elimination of the pathological process, a decrease in joint mobility is observed. The first signs occur a few weeks after the onset of the disease.
Causes of occurrence
Arthritis and arthrosis of the temporomandibular joint can be associated with the penetration of pathogens into the joint cavity. This can occur against the background of persistent tonsillitis, purulent inflammation of the parotid gland, otitis media and many other similar diseases. Together with the bloodstream, bacteria enter the joint cavity, where an inflammatory process forms.
Damage may result from injury. The disease can be a consequence of not only intense mechanical stress, but also occur with a sharp opening of the mouth. Failure to comply with antiseptic rules during surgery on the facial joint can also provoke an inflammatory reaction.
Rheumatoid arthritis occurs as a result of overheating, stress, hypothermia. In addition, heredity and frequent infectious diseases can be a provoking factor. Reactive arthritis can be associated with previous infections, in particular intestinal, urogenital.
Symptoms of the disease
Symptoms of arthritis of the temporomandibular joint largely depend on the cause of the disease, the stage of the inflammatory process, as well as the individual characteristics of the patient. Often, patients have an acute nonspecific type of arthritis, characterized by such signs as:
- intense soreness in the affected joint;
- swelling;
- redness of the skin.
With a purulent course of the inflammatory process, the patient's health deteriorates sharply, since the symptoms of general intoxication of the body join. With severe swelling in patients, hearing may be impaired due to narrowing of the ear canal. If there are purulent abscesses, then they can erupt on their own and penetrate the auditory canal. As a result of this, pus flows out of the ear. The chronic stage of the disease has less pronounced symptoms, in particular such as:
- slight soreness in the joints;
- stiff jaw movement;
- the presence of cod and crunch in the joints, tinnitus.
The prolonged course of the inflammatory process can provoke joint damage and limited mobility. Traumatic arthritis is accompanied by severe pain with limited joint mobility and hemorrhage.
Symptoms and treatment of arthritis of the temporomandibular joint largely depend on the nature and degree of damage to the joint tissue.
Diagnostics
If arthritis is suspected, consultation with a maxillofacial surgeon is required. Initially, the doctor determines the cause of the inflammatory process, since the methodology of therapy largely depends on this.
To diagnose the presence of a pathological process, an MRI scan, an x-ray, and computed tomography are required. In addition, laboratory tests are required. If a purulent lesion is detected during the course of the research, then the joint capsule is drained. In addition, the surgeon may refer for consultation with other specialists.
Disease treatment
The treatment of arthritis of the temporomandibular joint of various etiologies has its own specifics. In any case, it is imperative to provide rest to the diseased joint. For this, a bandage is made, which comes with a special plate. You can eat only liquid food.
When conducting therapy, it is imperative to eliminate pain, as well as remove excess blood that has penetrated the joint cavity. Treatment of arthritis of the temporomandibular joint implies:
- the use of analgesics;
- electrophoresis;
- compresses;
- mud therapy;
- paraffin therapy;
- UHF therapy.
The treatment of rheumatic and rheumatoid arthritis is carried out using conservative methods under the strict supervision of a rheumatologist. To do this, take anti-inflammatory drugs and antibacterial agents.
Special care requires the introduction of drugs, since it is forbidden to inject more than 1 ml of solution into the joint. Otherwise, pathological extension of the joint bag may occur. Purulent arthritis is especially dangerous , therefore urgent surgical intervention is required. The operation is performed in a hospital, and then conservative therapy is indicated. With improper treatment, the disease can go into the chronic stage.
Folk remedies
Treatment with alternative therapies is carried out in combination with traditional medication. To eliminate pain and relieve the inflammatory process, the use of warming ointments, compresses and various tinctures is indicated.
To prepare the tincture, you need to mix equal amounts of black radish juice with honey and vodka. Carefully rub the resulting mixture into the affected joint several times a day for a week.
Fir oil should be rubbed into the affected joint, as well as perform special gymnastics. This will allow you to quickly develop a damaged joint and give it mobility.
Preventive actions
Acute forms of arthritis with proper therapy can be cured, and they do not pose any danger to the life and health of the patient. However, it is worth remembering that during the transition of the disease to the chronic stage, surgery is required. In this regard, it is necessary to prevent the occurrence of arthritis.
Preventive measures include:
- injury prevention;
- timely treatment of damage;
- purification of purulent foci of inflammation;
- therapy of viral and infectious diseases;
- avoid overcooling the body.
It is imperative to properly and accurately treat dental diseases and monitor the condition of the oral cavity.