TMJ involvement in ankylosing spondylitis

Ankylosing spondylitis (AS) is a chronic auto-inflammatory disease of the joints, belonging to the group of spondylo-arthropathic disorders. The disease has a crippling effect on the axial skeleton and its progression to the later stages can have a debilitating effect on the patient. It has an under-diagnosed pathology and enigmatic pathophysiology. A strong genetic link has been found with the help of genome screening. Frequency of temporomandibular joint (TMJ) involvement in patients with ankylosing spondylitis (AS) has varied from 4% to 35%. It is more common in men and produces generalised stiffness in involved joints. Clinician should be suspicious of AS when a patient reports with painful restricted movements of joint, neck or back and with no trauma history. Conventional radiographic methods have allowed the demonstration of TMJ abnormalities in patients with AS, but cone beam computed tomography (CBCT) is necessary to establish joint space relations and bony morphology. We describe a case of severe AS with TMJ involvement in a 34-year-old male patient and demonstrated TMJ changes on CBCT.