Arthritis of a temporal and mandibular joint

Description:

Arthritis of a temporal and mandibular joint is an inflammatory or inflammatory and dystrophic disease of a temporal and mandibular joint.
The temporal and mandibular joint  is the combined joint. Its joint surfaces are covered with a fibrous cartilage. The joint is formed by a head of a mandible and a mandibular pole of a temporal bone. The joint surface of a mandibular pole is 2-3 times more than a mandible head. The surface has the ellipse form. Incongruence (discrepancy of surfaces of contact) between a head and a pole is leveled at the expense of a joint disk and an attachment of the capsule of a joint on a temporal bone.

Symptoms of Arthritis of a temporal and mandibular joint:

At arthritis of a temporal and mandibular joint there are complaints to pains of various intensity, beginning from embarrassment, unpleasant feelings in the affected joint and up to full switching off of its function. One of early and resistant symptoms of arthritises of inflammatory character is morning constraint. Constraint arises also in other time of day after more or less long dormant period of a jaw.

Other characteristic complaint of patients is joint noise. It can have the nature of friction, crepitation (rustling), a crunch, clicking.

Acute arthritis of a temporal and mandibular joint of traumatic character results from strong mechanical influence: blow, bruise, excessive opening of a mouth, etc.
There are complaints to sharp pain in a joint at the time of its damage. In attempt to open a mouth there are pains, the chin at the same time is displaced towards the injured joint. Hypostasis of soft tissues in the injured joint develops.

Acute arthritis of an infectious origin develops usually against the background of acute tonsillitis, overcooling, flu, etc. Rheumatic and pseudorheumatisms are result of hematogenous infection or spread of an infection on continuation at otitis, a mastoiditis, jaw branch osteomyelitis, purulent parotitis, etc.
There are severe pains in a joint amplifying in attempt to make the movements by a jaw. Pains can sometimes irradiate (to extend) in an ear, language, a temple, a nape. Opening of a mouth is limited - on 3-5 mm. Arises soft tissues of a kpereda from an ear trestle, at a palpation of this area there are pains, integuments which reddened.

Development of purulent arthritis is followed by formation of infiltrate (consolidation) in a joint, a hyperesthesia (sensitivity disturbance) of skin, it is strained, reddened. Outside acoustical pass is narrowed: decrease in auditory acuity, dizziness is observed. When pressing by a finger on a chin forward and up pains amplify. Body temperature is increased to 38 °C. At rheumatic arthritis damage of both joints is possible though it meets much less often. At the patient usually reveal heart diseases: defects, rheumatic carditis, etc.

At a pseudorheumatism one of temporal and mandibular joints is surprised, as a rule, but pains and in other joints can be noted: humeral, coxofemoral or knee. At the same time the temporal and mandibular joint very seldom is surprised the first. Visible changes of heart in patients are not found.

Chronic arthritis is characterized, the joint pains generally aching, rigidity, a crunch, constraint in the mornings and after more or less long condition of rest. There are spontaneous pains, constants amplifying at the movement of a mandible. The mouth opens on 2-2,5 cm. Opening of a mouth is followed moderate, and sometimes by a strong crunch, at the same time the chin is displaced towards the affected joint. Coloring of integuments, adjacent to it, can be not changed, but the joint palpation always causes strengthening of pains.
The general state remains satisfactory, body temperature normal. At a process aggravation the course of arthritis gains character of an acute inflammation.

Infectious and specific arthritises meet rather seldom. Distinguish gonorrheal, tubercular, actinomycotic, syphilitic arthritises, etc. They result from spread of an infection on continuation or at its penetration into a joint hematogenous (with a blood flow) or a lymphogenous way.

Reasons of Arthritis of a temporal and mandibular joint:

Depending on an origin of a disease distinguish infectious and traumatic arthritises, and on character of a current - acute and chronic. Infectious arthritises can be nonspecific and specific. Traumatic arthritises result from mechanical damage.

Treatment of Arthritis of a temporal and mandibular joint:

Treatment of acute arthritis is begun with ensuring rest to a joint. It is reached by means of individually made mitella and the interdental plate separating a bite or laying which is imposed on the party of defeat for a period of 2-3 days. Food has to be liquid.

Treatment at traumatic arthritis is carried out with the purpose to kill pains, to reach a rassasyvaniye of the blood which streamed in a joint in perhaps early terms and to achieve a complete recovery of function of a mandible. Appoint analgetics (analginum on 0,25 g 3 times a day) and a local hypothermia within 2-3 days, in posleduyushchem-UVCh-terapiyu 10-15 min. daily within 6 days, an electrophoresis of potassium of iodide and novocaine (serially). Compresses with ronidazy, parafino-or an ozoceritotherapy, mud cure can be at the same time recommended. At the proceeding pains appoint diadynamic currents of Bernard (2-3 sessions).

Upon transition of traumatic arthritises to a chronic stage appoint ultrasonic therapy, parafino-and ozokerito-therapy, massage of masseters, an electrophoresis of apitoxin, medical bile, iodine drugs. The good result is yielded by a miogimnastika: make the dosed opening of a mouth without promotion of a mandible. For this purpose the patient sits down on a chair, having leaned a nape against a wall, and a fist presses on a chin when opening and closing a mouth. Such exercises of the patient are done independently daily in the morning also by 2-3 more times during the day 3-5 min. for 4-6 weeks.

Treatment rheumatic and pseudorheumatisms is carried out by conservative means and it is obligatory together with the rheumatologist. The complex of the appointed treatment includes antiinflammatory nonsteroid, antibacterial, steroid drugs. Sanitation of an oral cavity of the patient and rational denture treatment for normalization of height of a bite is carried out.

At purulent arthritises operational treatment is shown: opening and drainage of the center of an inflammation which make in a hospital.
At a stage of an aftercare appoint physiotherapeutic treatment: dry heat, UVCh-therapy, electrophoresis, diathermy, compresses.

At untimely and insufficiently full treatment acute purulent and traumatic arthritises can be complicated by an anchylosis, especially at children. The current acute rheumatic and a pseudorheumatism can take the chronic form.