JOINT HYPERMOBILITY SYNDROME AND TEMPOROMANDIBULAR DISORDER IN A YOUNG MAN
DOI:
https://doi.org/10.11603/1811-2471.2025.v.i2.15324Keywords:
joint, mandible, syndrome, pyeloectasia, nephropathy, diagnosisAbstract
SUMMARY. The state of the connective tissue of the body is a key in the formation of the child's health, which depends on many external and internal factors. The main clinical criteria for the condition of the connective tissue is the mobility of the joints of the limbs, spine, if the range of motion exceeds the norm, then this condition is called hypermobility and is one of the main signs of its inferiority and requires further comprehensive examination by many specialists. Due to the development of modern diagnostic methods of examination, the number of children with dysplastic changes in connective tissue is increasing annually, which requires increased attention of specialists of various profiles. Methods for examining the joints of the limbs are well studied, which cannot be said about the temporomandibular joint (TMJ). The need to study this joint has grown so much that a new branch has arisen in dentistry that studies this particular joint - gnathology. The lack of information on this issue requires further study of this interesting problem.
The aim – to draw attention and focus on the clinical signs of temporomandibular disorder, which, during a comprehensive examination of other joints of the limbs and spine, will help to assess in more detail the syndromic manifestations of dysplastic changes in the child's connective tissue.
Material and Methods. The examination was carried out on the basis of the municipal non-profit enterprise "Ternopil Regional Children's Hospital" of the Ternopil Regional Council. The condition of the TMJ joint was assessed using a manual functional method – a short "Hamburg" examination, which included: assessment of the size of the mouth opening; characteristics of the movement of the lower jaw; determination of intra-articular noises; results of palpation of the masticatory muscles; the nature of tooth abrasion and the presence of supercontacts in lateral occlusions. The severity of the pain symptom was determined by subjective data on a ten-point scale. The mobility of the joints of the limbs and spine was assessed using the Beighton tests. The Adams test was done, as well as ECG and ultrasound examination of the abdominal organs was carried out using the SAMSUNG V8 ultrasound machine.
Results. A young man (18 years old) was examined who complained of crunching in the lower jaw, restriction of opening the mouth, pain when eating solid food. The patient had a habit to clench the teeth strongly, mainly during the day, after physical, mental overload (daytime bruxism). Temporomandibular disorder, moderate joint hypermobility syndrome, bilateral flat feet (clinically), kyphotic posture malformation, flat back syndrome, valgus deformity of both knee joints, hypothalamic pubertal syndrome, right-sided pyelectasia, dysmetabolic nephropathy, hepatomegaly were diagnosed.
Conclusions. Temporomandibular instability in combination with hypermobility of the joints of the limbs and a number of somatic diseases is a manifestation of the syndromic course of the disease – temporomandibular instability syndrome (TMS). In the presence of this syndrome, it is advisable to carry out a comprehensive examination of the child – ECG, ultrasound of the abdominal organs, X-ray examination of the musculoskeletal system, which will help to choose treatment and preventive measures.
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