A novel treatment of temporomandibular joint arthritis as a complication in familial Mediterranean fever-literature review and a case report.
OBJECTIVES
Articular involvement in familial Mediterranean fever (FMF) ranges between 40 and 70% of the patients. Involvement of temporomandibular joint (TMJ) in FMF is very rare, and only a few cases have been reported in the literature. There are no specific guidelines for treatment. We hereby present a new treatment for TMJ inflammation in FMF.


MATERIALS AND METHODS
A literature search was performed using PubMed according to the following criteria: key terms included in the search were FMF arthritis, TMJ involvement in FMF patients, and arthroscopy in FMF patients. All keywords were included both as medical subject headings (MeSH) terms and text words. Selections were limited to the English language.


RESULTS
Literature search yielded four reported cases of TMJ involvement in FMF patients. The four cases were treated differently, with no clear guidelines for management of TMJ involvement. Our patient suffered from painful swelling and redness over the involved TMJ area and severe trismus. She was treated by arthroscopic lysis and lavage of her TMJ followed by aggressive physiotherapy resulting to improvement of her mouth opening.


CONCLUSIONS
The adverse effect of TMJ arthritis in FMF patients can be avascular necrosis and destruction of the mandibular condylar head. TMJ arthroscopy allows lysis and lavage of the joint with minimal operative and postoperative complication, resulting with satisfactory results. Thus, in case of TMJ arthritis in FMF, we recommend TMJ arthroscopy as soon as possible, following aggressive physiotherapy in order to gain normal mouth opening.


CLINICAL RELEVANCE
FMF rates have been described among the Mediterranean and Middle Eastern population ranging from 1:5 to 1:3; thus, TMJ involvement due to the disease is not so rare in this region, and a clear treatment protocol is needed.
['Frenkel|Boaz|B|', 'Berg|Tal|T|', 'Totry|Amir|A|', 'Rachmiel|Adi|A|']
D000293:Adolescent D001182:Arthroscopy D003131:Combined Modality Therapy D010505:Familial Mediterranean Fever D005260:Female D006801:Humans D026741:Physical Therapy Modalities D013704:Temporomandibular Joint D013705:Temporomandibular Joint Disorders D007507:Therapeutic Irrigation
Temporomandibular joint arthritis Familial Mediterranean fever TMJ inflammation