Dr. Adams' Alabama Headache Blog

A recent investigation of the relative importance of systemic and local inflammatory mediator (serotonin; 5-HT; tumore necrosis factor, soluble interleukin-1 receptor II: IL-1sRII) in the modulation of the temporomandibular joint (TMJ) pressure pain in the threshold in patients with seropositive or seronegative rheumatoid arthritis (RA) and to investigate to what extent TMJ pressure pain threshold is related to other TMJ pain parameters. Statistical analyses indicated that TMJ pressure pain threshold was only correlated to systemic factors. TMJ movement pain was in turn mainly correlated to systemic mediators in the seropositive patients but to local mediators in the seronegative patients where synovial fluid IL-1sRIIwas positively correlated to TMJ pain on mouth opening. Seropositive patients had a higher systemic inflammatory activity but lower TMJ movement pain intensities than seronegative patients. The results indicate that TMJ pressure pain threshold is modulated by systemic rathar than local inflammatory mediators and suggest that it is unrelated or only weakly related to other TMJ pain entities RA patients. A rheumatoid factor-dependent systemic modulation, in combination with local factors, seems to account for TMJ pain in RA patients.