High prevalence of temporomandibular joint arthritis at disease onset in children with juvenile idiopathic arthritis, as detected by magnetic resonance imaging but not by ultrasound

Abstract

Objective. To determine the prevalence of temporomandibular joint (TMJ) disease in a cohort of children with new-onset juvenile idiopathic arthritis (JIA), and to compare magnetic resonance imaging (MRI) with ultrasound (US) for the detection of acute and chronic changes of TMJ arthritis.Methods. Between January 2005 and April 2007, children with newly diagnosed JIA were prospectively evaluated for TMJ arthritis. Prior to imaging, jaw pain and disability were assessed with questionnaires and physical examination. The TMJs of all patients were imaged with MRI and US within 8 weeks of diagnosis.Results. Of the 32 patients enrolled, 78% were female, and the median age was 8.6 years (range 1.5-17.2 years). Acute TMJ arthritis was diagnosed in 75% of the children by MRI and in none by US; chronic arthritis was diagnosed in 69% by MRI and in 28% by US. Findings of both acute and chronic TMJ disease were detected by MRI in 53% of the patients. Of those with acute TMJ arthritis, 71% were asymptomatic, and 63% had normal findings on jaw examination. Fifty-six percent of patients with acute disease had an improved maximal incisal opening after corticosteroid injection. Among these responders, 56% had been asymptomatic and had normal jaw examination findings.Conclusion. TMJ arthritis was present in the majority of patients with new-onset JIA. Findings on MRI along with responses to treatment among asymptomatic patients with normal jaw examination findings suggest that a history review and physical examination are not sufficient to screen for TMJ disease. Our results also suggest that MRI and US findings are not well correlated, and that MRI is preferable for the detection of TMJ disease in new-onset JIA.

Temporomandibular Joint Arthritis in Pediatric Sjögren Disease and Sarcoidosis

“…It is usually painless and even minor radiographic changes of the TMJ have been associated with disruption in mandibular growth and a number of other craniofacial changes 1 . Recently, magnetic resonance imaging (MRI) evaluations have proven to have much greater sensitivity to detect arthritis compared to ultrasound, and placed the prevalence of TMJ arthritis in this population between 63% and 75% 2,3 . Due to this high prevalence, patients with JIA frequently receive contrast-enhanced MRI scans of the TMJ as a standard evaluation for arthritis in several clinical centers.…”

Long-term Follow-up of Craniofacial Alterations in Juvenile Idiopathic Arthritis

“…The reported frequency of TMJ involvement ranges in the literature from 17% to 87%, depending on the population investigated, the subtypes represented, and the radiologic method by which involvement is diagnosed. [5][6][7][8][9][10][11][12][13][14] Only one study reported the incidence of TMJ involvement in all subtypes of JIA. 6 The most important site of growth of the mandible in the vertical and sagittal direction is located on the articular surface of the condylar head.…”

“…6 The most important site of growth of the mandible in the vertical and sagittal direction is located on the articular surface of the condylar head. [12][13][14][15] During nor- mal growth of the dentomaxillary complex, the vertical dimension increases more than the sagittal dimension does. Arthritis of the TMJ results in reduced mandibular growth and subsequent alteration in dental occlusion and may even affect total craniofacial growth.…”

O uso do hialuronato de sódio no tratamento das disfunções temporomandibulares articulares

“…Individuals with such changes have major impact in their quality of life, with impairment of their functional activities and, very often, with mood and sleep changes 3 . TMD prevalence in general population varies from 10% to 70%, being more frequent among females between 20 and 40 years of age 3,4 . Among joint TMD, reducing and nonreducing disk displacements and osteoarthritis are more frequent changes in patients looking for treatment [3][4][5] .…”

“…TMD prevalence in general population varies from 10% to 70%, being more frequent among females between 20 and 40 years of age 3,4 . Among joint TMD, reducing and nonreducing disk displacements and osteoarthritis are more frequent changes in patients looking for treatment [3][4][5] . Different approaches have been proposed to control such disorders, among them conservative treatments (drugs, physiotherapy, stabilizing and repositioning occlusal devices, guidelines), minimally invasive treatments (sodium hyalorunate or corticosteroid infiltrations and arthrocentesis), and invasive treatments (arthroscopy, arthroplasty, arthrotomy) [6][7][8] .…”