Akademik Veri Yönetim Sistemi
AÇBİD 16th International Congress, Antalya, Türkiye, 10 - 14 Mayıs 2023, ss.17
Objective: Familial Mediterranean fever (FMF) is a hereditary autoinflammatory disorder
characterized by recurrent fevers, serositis, and inflammation without any infection. Psoriasis is
a common chronic immune-mediated inflammatory disorder manifesting in the skin, joints, or
both. Articular involvement, usually seen in medium - large joints, ranges between 40 and 70% of
FMF patients. However, temporomandibular joint(TMJ) involvement in FMF is rarely seen. On the
other hand, psoriatic arthritis(PsA) develops approximately in one out of every five patients with
psoriasis. This study aims to present an FMF case that is simultaneously affected with psoriasis.
Case: A 40-year-old female patient presented with complaints of pain in the right TMJ
region and limitation in opening the mouth. History revealed that the patient had been under
treatment with FMF but also previously treated for psoriasis. In regards to TMJ problem,
patient was treated with medical treatments, occlusal splints, and several arthrocentesis which
all failed. Preliminary diagnosis as ankylosis and verified with advanced imaging modalities.
After clinical and radiological evaluations, a disc was not detected in the intraarticular space,
and deformation in the right TMJ, fibrotic changes, and ankylosis due to the advanced stage
of arthritis were diagnosed. Under general anesthesia, open TMJ surgery for the release of
ankylosis was carried out.
Conclusion: Anesthetic sprays, intraarticular dexamethasone injections, arthroscopic lysis,
lavage, and physical therapy are recommended for the treatment of TMJ involvement in FMF or
psoriasis patients. In cases where there is no response to these treatments, open TMJ surgery
may be the only treatment option.
Keywords: Ankylosis, Familial Mediterranean fever, Psoriatic arthritis