Temporomandibular joint dysfunction as the first articular manifestation of Psoriatic Arthritis: a case report

Aim: The aim of this study is to present a clinical case in which temporomandibular joint dysfunction (TMD) represented the first articular manifestation of psoriatic arthritis (PA), and to highlight the importance of an interdisciplinary approach for timely diagnosis and appropriate management of the condition. Materials and Methods: A case study was conducted on a patient presenting with pain and functional limitation in the temporomandibular joint (TMJ}. The diagnostic process included a clinical evaluation of mandibular movements, assessment of pain intensity, presence of joint noises and deviations during movement, as well as imaging studies to detect possible signs of joint degeneration. Laboratory tests were performed to analyze inflammatory markers, rheumatoid factors, and autoantibodies typically associated with PA. A detailed medical and family history was also collected to identify possible predisposing factors. Following diagnosis, treatment involved a multidisciplinary approach consisting of non-steroidal anti-inflammatory drugs (NSAIDs), disease-modifying antirheumatic drugs (DMARDs), the use of occlusal splints to reduce TMI load, and physiotherapy sessions with targeted exercises aimed at restoring joint function and reducing pain. Collaboration with the rheumatology team enabled continuous monitoring of clinical progression and adjustments to the therapeutic plan when necessary. Results and Conclusions: Imaging revealed TMJ degenerative changes, and lab results indicated systemic inflammation consistent with PA. TMD may be an early sign of PA, highlighting the importance of a multidisciplinary approach for timely diagnosis and treatment. Combined pharmacological, dental, and physiotherapy interventions significantly reduced symptoms, improved joint function, and prevented further damage.