While PsA commonly affects peripher – al joints such as the hands, feet, and spine, it can also involve the tem – poromandibular joint (TMJ). The National Psoriasis Foundation estimates 35% of peo – ple with PsA experience symptoms in their TMJ. This can significantly impair QOL due to pain and functional limitations.
“PsA affecting the TMJ represents a unique subset of PsA manifestations that requires special attention,” said Sara Bernardi, DDS, and coauthors of a review published in Dentistry Journal.
TMJ involvement in PsA presents with a range of symptoms, predominantly pain, which can radiate to surrounding areas such as the face and neck. Patients often describe the pain as dull or throbbing, exacerbated by jaw movement. Additional symptoms in – clude joint swelling, limited jaw movement, and crepitus (clicking or popping sounds), indicative of joint damage.
“The consequences of TMJ involvement in PsA can be debilitating, significantly affect – ing an individual’s ability to eat, speak, and perform daily activities,” the authors wrote.
They emphasized the gender disparities in PsA manifestation and severity. Studies sug – gest that men typically exhibit more periph – eral joint involvement and greater disease severity, whereas women often present with axial involvement, including the TMJ. Hor – monal fluctuations, particularly in women, play a role in these differences, according to the review authors. Estrogen and other sex hormones may influence inflammation and pain perception, contributing to the high – er prevalence of TMJ disorders in women. Additionally, women report higher levels of pain and psychological distress associated with PsA.
Dr. Bernardi and colleagues wrote that diag – nosing PsA with TMJ involvement requires a thorough medical history and physical exam – ination, focusing on rheumatological disease. Radiological imaging, such as CT and MRI, is crucial for assessing bone and soft tissue health. TMJ-specific diagnostic signs include cortical erosion, joint space narrowing, and osteophytic lesions. Differentiating PsA from other conditions like osteoarthritis or rheu – matoid arthritis involves noting the pattern of bone erosions and genetic or rheumatoid factor analyses.
“Recognizing the clinical presentation, understanding the underlying pathogenesis, and tailoring treatment strategies are essential in managing this condition effectively. By fostering interdisciplinary collaboration and investing in further research, healthcare providers can pave the way for improved diagnosis and treatment and, ultimately, enhance patient outcomes,” the review authors concluded.
