Introduction: Rheumatoid arthritis (RA) is a systemic, autoimmune disease characterized by synovial hyperplasia and chronic inflammation, which can also show temporomandibular joint (TMJ) involvement. This case report aimed to present the clinical and radiological findings of a rheumatoid arthritis patient with TMJ involvement.

Case: A 69-year-old male patient applied to Akdeniz University Oral and Maxillofacial Radiology Department with current dental complaints and TMJ pain. In his medical history, it was learned that he had been diagnosed with rheumatoid arthritis for 12 years and had been using drugs containing hydroxychloroquine and prednisolone. Extraoral examination revealed pain on opening and closing the mouth and bilateral crepitation sound. There was no limitation in mouth opening, deviation and deflection. Panoramic radiograph showed multiple radiopacities and flattening in the left condyle head and resorption in the anterior of the right condyle head, and cone beam computed tomography (CBCT) was requested from the patient. Findings on CBCT images were compatible with panoramic radiography. The patient was referred to the Department of Oral and Maxillofacial Surgery with a preliminary diagnosis of TMJ RA.

Discussion/Conclusion: Studies have shown that TMJ involvement is quite high in individuals with rheumatological disease. When TMJ is affected by RA, joint stiffness, difficulty in mouth opening, and open bite symptoms may occur. The fact that the changes in the condyle are bilateral, especially in RA, is helpful in radiographic differential diagnosis. In order to reach a definitive diagnosis, cross-sectional images should be used as well as clinical and radiographic findings, and the patient should be evaluated in terms of rheumatology.

Keywords: rheumatoid arthritis, temporomandibular joint, cone beam computed tomography