Rheumatoid arthritis (RA) is a systemic inflammatory, slowly progressive disease that results in cartilage and bone destruction. Temporomandibular joint (TMJ) involvement is not uncommon in RA, and it is present in about more than 50% of patients; however, TMJ is usually among the last joints to be involved and is associated with many varied clinical signs and symptoms. Hence, RA of TMJ presents to the dentist with great diagnostic challenges. This report presents a case of RA with bilateral TMJ involvement with its classical radiographic findings and review literature. 1. Introduction “Rheumatoid arthritis (RA) is a chronic inflammatory disease characterized by joint swelling, joint tenderness, and destruction of synovial joints, leading to severe disability and premature mortality [1, 2].” The first recognized description of RA was made in 1800 by Dr. Augustin Jacob Landré-Beauvais of Paris [3]. A B Garrod in 1858 named the disease rheumatoid arthritis replacing the old terms arthritis deformans and rheumatic gout [3]. He is thus credited to make a distinction between rheumatoid arthritis, osteoarthritis, and gout [4]. In 1932 the International Committee on Rheumatism was formed which later became American Rheumatism Association and then American College of Rheumatology [4]. TMJ complaints are present in about more than 50% of patients of RA [4, 5]. TMJ is usually among the last joint to be involved and is associated with many clinical signs and symptoms of which pain is a major problem later leading to inflammation, limited movements, swelling (joint stiffness), and muscle spasm [6]. If it occurs in early age it may result in mandibular growth disturbance, facial deformity, and ankylosis and in adult these can vary from mild joint stiffness to total joint disruption with occlusal-facial deformity [7, 8]. The diagnosis of TMJ involvement in RA is exclusionary based on history, physical findings, radiographic study, and lab testing. Hence a multidisciplinary approach is necessary [8, 9]. The present paper reports a case of RA with bilateral TMJ involvement with its classical radiographic findings. 2. Case Report A 29-year-old female patient complained of pain in front of ear bilaterally and discomfort during mouth opening since last 2 months. Associated complains reported anorexia, nervousness, fatigue, and weakness. Four weeks later she began to feel continuous throbbing pain in the joints which aggravated during chewing. Gradually the pain became very intense, making it difficult for the patient to open the mouth, associated with clicking sound while
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