顎関節に症状を来たしたリウマチ性多発筋痛症の1例

抄録

Polymyalgia rheumatica (PMR) is an inflammatory disease of unknown etiology characterized by pain and stiffness affecting proximal portions of the arms and legs of elderly persons. A case of PMR associated with a chief complaint of temporomandibular joint symptoms, which has not been previously reported, is presented.
An 81-year-old woman with fever and pain in the proximal parts of her arms and legs presented to our hospital because of pain and swelling of the right temporomandibular joint, locked jaw, and occlusal dysfunction. Temporomandibular joint suppurative arthritis was suspected on the basis of an increased C-reactive protein level and joint effusion of the right temporomandibular joint cavity on magnetic resonance imaging (MRI). She was given an intravenous drip infusion of antibiotics, but there was no response. Similar symptoms developed in the contralateral temporomandibular joint; consequently, the patient had difficulty in getting up in the morning and walking because of increasing pain and stiffness in the proximal parts of the arms and legs. She visited an internist and was given a diagnosis of PMR. Oral prednisone, 15 mg/day, was prescribed, and symptoms, including the temporomandibular joint symptoms, improved rapidly. However, because the patient is positive for anti-cyclic citrullinated peptide antibody there is a risk of elderly onset rheumatoid arthritis; longterm follow-up is therefore necessary.