Equine temporomandibular joint diseases: A systematic review.
Authors: Jasiński, Turek, Kaczorowski, Brehm, Skierbiszewska, Domino
Journal: Equine veterinary journal
Summary
# Equine Temporomandibular Joint Disease: What the Evidence Shows Temporomandibular joint disease (TMD) remains poorly characterised in equine practice, despite affecting joint function with variable clinical consequences ranging from mild to severe. A comprehensive systematic review of 51 publications reveals that septic arthritis (41.2% of cases) and trauma-related conditions including fractures and luxations (29.4%) dominate the clinical picture, with primary osteoarthritis accounting for 21.6%—notably, trauma was confirmed or suspected in 54.9% of all cases. Computed tomography emerged as the predominant diagnostic tool (used in 92.2% of documented cases), though radiography proved more accessible in field settings (84.4% utilisation), while ultrasonography featured minimally (21.6%). The authors recommend a standardised diagnostic protocol incorporating thorough history-taking, detailed palpation of the TMJ, radiography as first-line imaging in practice, and computed tomography as the definitive diagnostic standard, with bacterial culture for suspected septic cases and functional assessment with local analgesia reserved for suspected osteoarthritis. Given that TMD literature remains fragmented with significant data gaps, equine professionals should maintain heightened awareness of TMJ involvement in cases of asymmetrical swelling, pain on palpation, or masticatory dysfunction, whilst recognising that diagnostic approach must be tailored to the clinical context and suspected underlying cause.
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Practical Takeaways
- •Always obtain a thorough history and perform detailed TMJ examination for suspected cases; radiography is the first-line imaging in field practice, with CT reserved for clinical settings as the gold standard
- •Trauma accounts for over half of TMD cases—investigate mechanisms of injury and consider TMJ involvement in horses with history of facial/head trauma, TMJ swelling, or masticatory dysfunction
- •Diagnostic protocols should be tailored to the suspected condition: bacterial culture for septic arthritis, functional tests and local analgesia for primary OA, ensuring appropriate treatment planning
Key Findings
- •Equine TMD has been described in 51 publications with septic arthritis accounting for 41.2% of cases, fractures/luxations 29.4%, and primary OA 21.6%
- •Trauma was confirmed or suspected in 54.9% of TMD cases, making it the most common cause
- •CT imaging was utilised in 92.2% of horses studied, radiography in 84.4%, and ultrasonography in only 21.6%
- •Clinical signs ranged from mild to moderate in primary TMJ OA and mild to severe in septic arthritis and non-arthritic TMDs