Cytopathologic diagnosis on joint lavage fluid for patients with temporomandibular joint disorders

Abstract

Temporomandibular joint (TMJ) disorders (TMD) are usually diagnosed based on the patient's clinical findings and the results of image investigations; however, understanding of the inflammatory process in TMJ is difficult. In addition, many of the TMJ disease types share common principal symptoms. Therefore, TMJ diseases in the early stage can be misdiagnosed with TMD. It is hypothesized that cytopathologic examination of the joint lavage fluids is useful in interpreting the TMD-associated inflammatory process from a cellular aspect. The aim of this study was to assess the TMJ lavage fluid cytopathologically in TMD patients. Thirty-nine patients, clinically diagnosed as TMD, were included in the present study. Clinical symptoms of the patients were recorded. Forty-four samples of TMJ lavage fluid were collected and paraffin-embedded cell sections were made by cell block tissue array method. Cytologic conditions in upper articular cavity of TMJ were cytopathologically diagnosed and were compared with the clinical symptoms of each patient. Cell components were detected in 22 of the 44 analyzed joint lavage fluids. There was a correlation between cytopathologic findings and clinical symptoms. Variety of cytopathology and inflammatory conditions in patients with similar clinical symptoms were also found. The results suggested that cytopathologic examination of the joint lavage fluids from TMD patients is helpful for gaining an understanding of the inner local conditions of TMJ at the cellular level.

P2X7‐induced nociception in the temporomandibular joint of rats depends on inflammatory mechanisms and C‐fibres sensitization

“…The neutrophil is the first immune cell to enter into inflamed tissues and it has been associated with the development and chronicity of inflammatory diseases, such as TMD (Mikami et al, 2014). Also, leukocytes are present in the joint fluid of approximately 50% of patients with TMD (Mikami et al, 2014).…”

“…The neutrophil is the first immune cell to enter into inflamed tissues and it has been associated with the development and chronicity of inflammatory diseases, such as TMD (Mikami et al, 2014). Also, leukocytes are present in the joint fluid of approximately 50% of patients with TMD (Mikami et al, 2014). Moreover it has been shown that ATP released in an inflamed joint, via P2X7 receptor activation, induces articular hyperalgesia that depends on neutrophil migration (Teixeira et al, 2017).…”

There is more than meet the eyes in head and neck cytopathology

“…As regional specialist surgeons, these specialist treat the entire cranio‐maxillo‐facial anatomical complex, that is: the mouth, jaws, face, skull, as well as associated soft tissue structures. As such, they may perform FNA and other biopsies of lumps and bumps as needed, but conventional cytology may also be utilized for the study of synovial fluid or lavage fluid from the temporo‐mandibular joints . How often most of us examine a bony or soft tissue tumor of the skull, as part of our routine head and neck cytopathology practice, as opposed to our colleagues in orthopedic cytopathology depends on local circumstances.…”