References

Adams K, Schulz-Kornas E, Arzi B, Failing K, Vogelsberg J. Functional anatomy of the equine temporomandibular joint: Histological characteristics of the articular surfaces and underlining tissues. Vet J. 2018; 239:35-41 https://doi.org/10.1016/j.tvjl.2018.08.003

Balducci J, Ruby J, Hall C, Williams J. Arthrotomy, curettage and medical management of septic arthritis and osteomyelitis of the temporomandibular joint in a horse. Equine Vet Educ. 2019; https://doi.org/10.1111/eve.13156

Barber SM, Doige CE, Humphreys SG. Mandibular condylectomy technique and results in normal horses. Vet Surg. 1985; 14:79-86 https://doi.org/10.1111/j.1532-950x.1985.tb00831.x

Barnett TP, Powell SE, Head MJ, Marr CM, Steven WM. Partial mandibular condylectomy and temporal bone resection for chronic, destructive, septic arthritis of the temporomandibular joint in a horse. Equine Vet Educ. 2013; 26:59-63 https://doi.org/10.1111/eve.12053

Bienert-Zeit A, Rötting A. Unilaterale mandibuläre Kondylektomie bei einem adulten Warmblutwallach. Pferdeheilkunde. 2011; 27:231-236

Carmalt J. Equine TMJ disease. Equine Vet Educ. 2014; 26:64-65 https://doi.org/10.1111/eve.12103

Carmalt JL, Wilson DG. Arthroscopic treatment of temporomandibular joint sepsis in a horse. Vet Surg. 2005; 34:55-58 https://doi.org/10.1111/j.1532-950x.2005.00010.x

Carmalt JL, Gordon JR, Allen AL. Temporomandibular joint cytokine profiles in the horse. J Vet Dent. 2006; 23:83-88 https://doi.org/10.1177/089875640602300204

Carmalt JL, Linn KA. Large segmental mandibulectomy for treatment of an undifferentiated sarcoma in a horse: large segmental mandibulectomy. Vet Surg. 2013; 42:433-439 https://doi.org/10.1111/j.1532-950x.2013.01086.x

Carmalt JL, Kneissl S, Rawlinson JE Computed tomographic appearance of the temporomandibular joint in 1018 asymptomatic Horses: A multi-institution study. Vet Radiol Ultrasound. 2016; 57:237-245 https://doi.org/10.1111/vru.12334

Devine DV, Moll HD, Bahr RJ. Fracture, luxation, and chronic septic arthritis of the temporomandibular joint in a juvenile horse. J Vet Dent. 2005; 22:96-99 https://doi.org/10.1177/089875640502200204

Ebling AJ, McKnight AL, Seiler G, Kircher PR. A complementary radiographic projection of the equine temporomandibular joint. Vet Radiol Ultrasound. 2009; 50:385-391 https://doi.org/10.1111/j.1740-8261.2009.01554.x

Frietman SK, Proosdij ER van, Veraa S, de Heer N, ter Braake F. A minimally invasive partial condylectomy and temporal bone resection for the treatment of a suspected chronic synovial sepsis of the temporomandibular joint in a 3.5-year-old paint horse gelding. Vet Quart. 2019; 38:118-124 https://doi.org/10.1080/01652176.2018.1535216

Guerrero Cota JM, Leale DM, Arzi B, Cissell DD. Regional and disease-related differences in properties of the equine temporomandibular joint disc. J Biomech. 2019; 82:54-61 https://doi.org/10.1016/j.jbiomech.2018.10.017

Hardy J, Shiroma JT. What is your diagnosis? Rostral luxation of the right temporomandibular joint. J Am Vet Med Assoc. 1991; 198:1663-1664

Hurtig MB, Barber SM, Farrow CS. Temporomandibular joint luxation in a horse. J Am Vet Med Assoc. 1984; 185:78-80

Jank S, Emshoff R, Norer B, Missmann M, Nicasi A. Diagnostic quality of dynamic high-resolution ultrasonography of the TMJ—a pilot study. Int J Oral Max Surg. 2005; 34:132-137 https://doi.org/10.1016/j.ijom.2004.03.014

Jørgensen E, Christophersen M, Kristoffersen M, Puchalski S, Verwilghen D. Does temporomandibular joint pathology affect performance in an equine athlete?. Equine Vet Educ. 2015; 27:126-130 https://doi.org/10.1111/eve.12268

Klopfenstein Bregger MD, Koch C, Zimmermann R, Sangiorgio D, Schweizer-Gorgas D. Cone-beam computed tomography of the head in standing equids. BMC Vet Res. 2019; 15

May KA, Moll HD, Howard RD, Pleasant RS, Gregg JM. Arthroscopic anatomy of the equine temporomandibular joint. Vet Surg. 2001; 30:564-571 https://doi.org/10.1053/jvet.2001.28438

Nagy A, Simhofer H. Mandibular condylectomy and meniscectomy for the treatment of septic temporomandibular joint arthritis in a horse. Veterinary Surg. 2006; 35:663-668 https://doi.org/10.1111/j.1532-950x.2006.00205.x

Norvall A, Cota J, Pusterla N, Cissell D. Ultrasound-guided arthrocentesis of the temporomandibular joint in healthy adult horses is equivalent to blind arthrocentesis. Vet Radiol Ultrasound. 2020; 61:(3)346-352 https://doi.org/10.1111/vru.12836

Patterson LJ, Shappell KK, Hurtig MB. Mandibular condylectomy in a horse. J Am Vet Med Assoc. 1989; 195:101-102

Perrier M, Schwarz T, Gonzalez O, Brounts S. Squamous cell carcinoma invading the right temporomandibular joint in a Belgian mare. Can Vet J. 2010; 51:885-887

Ramzan L, Marr CM, Meehan J, Thompson A. Novel radiographic projection of the temporomandibular articulation of horses. Vet Rec. 2008; 162:714-716

Rodríguez M, Agut A, Gil F, Latorre R. Anatomy of the equine temporomandibular joint: study by gross dissection, vascular injection and section. Equine Vet J. 2006; 38:143-147 https://doi.org/10.2746/042516406776563378

Rodríguez MJ, Soler M, Latorre R, Gil F, Agut A. Ultrasonographic anatomy of the temporomandibular joint in healthy pure-bred Spanish horses. Vet Radiol Ultrasound. 2007; 48:(2)149-154 https://doi.org/10.1111/j.1740-8261.2007.00223.x

Rodríguez M, Latorre R, Lopez-Albors O, Soler M, Guirre C, Vazquez JM, Querol M, Agut A. Computed tomographic anatomy of the temporomandibular joint in the young horse. Equine Vet J. 2008; 40:(6)566-571 https://doi.org/10.2746/042516408x322166

Rodríguez M, Agut A, Soler M, Lopez-Arredondo J, Querol M, Latorre R. Magnetic resonance imaging of the equine temporomandibular joint anatomy. Equine Vet J. 2010; 42:(3)200-207 https://doi.org/10.1111/j.2042-3306.2010.00030.x

Rosenstein DS, Bullock MF, Ocello PJ, Clayton HM. Arthrocentesis of the temporomandibular joint in adult horses. Am J Vet Res. 2001; 62:729-733 https://doi.org/10.2460/ajvr.2001.62.729

Sanders RE, Schumacher J, Brama PAJ, Zarelli M, Kearney CM. Mandibular condylectomy in a standing horse for treatment for osteoarthritis of the temporomandibular joint. Equine Vet Educ. 2014; 26:(12)624-628 https://doi.org/10.1111/eve.12235

Schumacher J. The equine temporomandibular joint. Focus Meeting on Equine Dentistry. American Assoc. of Equine Pract. 2006; 160-164

Smyth T, Allen AL, Carmalt JL. Clinically significant, nontraumatic, degenerative joint disease of the temporomandibular joints in a horse. Equine Vet Educ. 2017; 29:72-77 https://doi.org/10.1111/eve.12382

Stadtbäumer G, Boening KJ. Diagnostische und minimal-invasive Verfahren am Kiefergelenk des Pferdes. Tierärztl Prax. 2002; 30:(G)99-106

Tietje S, Becker M, Böckenhoff G. Computed tomographic evaluation of head diseases in the horse: 15 cases. Equine Vet J. 1996; 28:(2)98-105 https://doi.org/10.1111/j.2042-3306.1996.tb01599.x

Townsend NB, Cotton JC, Rakzai SZ. A Tangential radiographic projection for investigation of the equine temporomandibular joint. Veterinary Surg. 2009; 38:601-606 https://doi.org/10.1111/j.1532-950x.2009.00536.x

Warmerdam EP, Klein WR, Herpen BP van. Infectious temporomandibular joint disease in the horse: computed tomographic diagnosis and treatment of two cases. Vet Rec. 1997; 141:172-174 https://doi.org/10.1136/vr.141.7.172

Weller R, Taylor S, Maierl J, Cauvin ERJ, May SA. Ultrasonographic anatomy of the equine temporomandibular joint. Equine Vet J. 1999a; 31:(6)529-532 https://doi.org/10.1111/j.2042-3306.1999.tb03863.x

Weller R, Cauvin ER, Bowen IM, May SA. Comparison of radiography, scintigraphy and ultrasonography in the diagnosis of a case of temporomandibular joint arthropathy in a horse. Vet Rec. 1999b; 144:377-379 https://doi.org/10.1136/vr.144.14.377

Weller R, Maierl J, Bowen IM, May SA, Liebich HG. The arthroscopic approach and intra-articular anatomy of the equine temporomandibular joint. Equine Vet J. 2002; 34:(4)421-424 https://doi.org/10.2746/042516402776249155

Witte TH. TMJ pathology: is it real?. Equine Vet Educ. 2016; 28:(3)173-174 https://doi.org/10.1111/eve.12340

CPD article: Arthropathy of the temporomandibular joint: a diagnostic challenge

02 September 2020
8 mins read
Volume 4 · Issue 5
Figure 1. Transverse computed tomography image of a horse with left-sided septic arthritis of the temporomandibular joint. There is a narrowed joint space (yellow arrow), irregular joint surface, moth-eaten appearance of the subchondral bone of the mandibular condyle and the temporal bone (yellow arrowhead). Mild periosteal reaction is visible at the ventral margin of the left mandibular condyle and the dorsal aspect of the temporal bone (red arrow).
Figure 1. Transverse computed tomography image of a horse with left-sided septic arthritis of the temporomandibular joint. There is a narrowed joint space (yellow arrow), irregular joint surface, moth-eaten appearance of the subchondral bone of the mandibular condyle and the temporal bone (yellow arrowhead). Mild periosteal reaction is visible at the ventral margin of the left mandibular condyle and the dorsal aspect of the temporal bone (red arrow).

Abstract

Equine temporomandibular joint arthropathy has been described as an underlying cause of various clinical signs. The anatomy of this incongruent joint is well described, as well as its appearance on different imaging modalities. However, pathologies of this joint are rare. This article provides an overview of the literature. Multiple possible aetiologies of temporomandibular joint arthropathy are not supported by current research and must be revised. Likewise, the imaging diagnosis or the classification of clinically relevant findings is difficult. A critical examination of this disease, including multiple diagnostic modalities, should be carried out to verify the clinical significance of findings in every case.

The term arthropathy includes all diseases of the joint, and equine temporomandibular joint arthropathy has been described as a potential underlying cause of a diverse collection of clinical signs including changes in accepting the bit, gait abnormalities, sour attitude, headshaking, atrophy of the masseter muscle (Sanders et al, 2014), pain on palpation, and masticatory problems (Patterson et al, 1989; Nagy and Simhofer, 2006). However, diseases of the temporomandibular joint such as non-septic osteoarthritis, osteoarthrosis or degenerative joint disease (Stadtbäumer and Boening, 2002; Smyth et al, 2017) are rarely reported. Most single case reports describe septic arthritis (Patterson et al, 1989; Warmerdam et al, 1997; Carmalt and Wilson, 2005; Devine et al, 2005; Nagy and Simhofer, 2006; Barnett et al, 2013; Balducci et al, 2019; Frietman et al, 2019) (Figures 1 and 2) or joint luxation (Hurtig et al, 1984; Hardy and Shiroma, 1991; Devine et al, 2005).

Register now to continue reading

Thank you for visiting UK-VET Equine and reading some of our peer-reviewed content for veterinary professionals. To continue reading this article, please register today.