# Temporomandibularibular Disorders and Serological Tests in Patients with Rheumatoid Arthritis
## 1 Introduction
Consequently, it is essential to recognize EAM because the management is frequently aimed at controlling the underlying RA disease [2]. Among the most frequent manifestations are keratoconjunctivitis, the inflammation of the cornea and conjunctiva, which manifests itself as burning, itchy eyes, pressure behind the eye, or a feeling of grititiness in the eye. Among the less frequent but more destructive processes is scleritis, which is characterized by a very painful inflammation of the sclera. Pleuro-pulmonary involvement is common in RA, and pleural effusions may be found on routine chest X-rays. Patients with pleural effusions may not have symptoms and may not need any therapy, as effusions usually resolve spontaneously or with the management of the joint disease. Lung nodules also may be reported in patients with RA. They usually appear in patients with long-standing RA pathology and patients with concomitant subcutaneous rheumatoid nodules. The prognosis of rheumatoid pulmonary nodules is commonly good, but monitoring for potential neoplasms is necessary, especially in those subjects who have a history of smoking [1; 2; 3]. Male patients, subjects who are older at the onset of the disease, and those with more severe disease show a greater risk of developing ILD. Considering the systemic inflammatory nature of RA, the main cardiac manifestation in these patients is atherosclerosis. Several studies have found increased cardiovascular morbidity in patients with RA; compared to age- and sex-matched controls, patients with RA present an increased risk of cardiovascular death, ischemic heart disease, and heart failure. Osteoporosis in RA occurs from an interaction of factors, comprising systemic and local inflammation, patient immobilization caused by joint damage and pain, and the associated treatment with glucocorticoids. Hematologic anomalies are usual in RA, and bone marrow suppression may result from both pathological processes and drug therapy. Clinically, this may present as anemia, leukopenia, neutropenia, eosinophil, thrombocytopenia, anemia of long-term disease is the most frequent anomaly, which may present concurrently with iron deficiency anemia and will tend to improve with good disease control. Mononeuritis multiplex is an asymmetric sensory and/or motor peripheral neuropathy that destroys at least two separate, apparently random, nerve areas. Mononeuritis multiplex is usual in diabetes but may also be seen in vasculitis, like RA [2]. Regarding the diagnostic criteria, there are three key factors indicating probable RA according to the more updated classification (ACR/EULAR 2010 Classification) [13]: symmetrical arthritis of small joints (swelling and morning joint stiffness), symptoms lasting longer than 6 weeks, elevated concentrations of C-reactive protein (CRP) or erythrocyte sedimentation rate (ESR), presence of anticitrullinated protein antibodies (ACPA), rheumatoid factor (RF) (when its titer is three times increased), or anti-nuclear antibody (ANA) [6; 14; 15; 16; 17; 18]. However, currently, there are no single pathognomic laboratory or imaging findings that definitively diagnose this disease [19]. Although structural changes, which can be visualized by conventional X-rays or other imaging techniques, best distinguish RA from other arthitic disorders, joint damage is rarely apparent in the very early stages of disease, but rather accumulates consistently over time [1]. Therefore, RA diagnosis is also, and above all, clinical, based on the pattern of the following physical symptoms, i.e., swollen joints, redness at affected joints, joint stiffness in the morning, low-grade fever, fatigue, and loss of appetite [19]. The early diagnosis and treatment of RA have extensively shown a strong potential for the improvement of disease outcomes. Established evidence supports the impact of early interventions in terms of early disease activity control, leading to a lower rate of radiographic progression and development of disability.