Juvenile idiopathic arthritis and the temporomandibular joint

Mohammed, Yasser; Saeed, Ola M.; Zaghloul, Nayera; Samer, Sahar; Mahmud, Samah; Abdulah, Ahmad

doi:10.1016/j.ajme.2011.11.004

Cited by 9 publications

(4 citation statements)

References 21 publications

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“…Therefore, the MRI findings were carefully graded into different stages of inflammation and deformity by two experienced paediatric radiologists. The high frequency of TMJ involvement in our sample (71 %) is in line with previous studies [ 2 , 5 , 29 ] with MRI based diagnosis [ 8 , 19 , 30 , 31 ]. We found a higher than expected frequency of TMJ involvement in patients with oligoarticular arthritis (70 %) or enthesitis related arthritis (77 %) than previous studies [ 6 ] which is likely due to our small study sample.…”

Section: Discussionsupporting

confidence: 92%

“…The latter study however applied a different definition of active TMJ arthritis, namely assessing effusion or synovial thickening instead of enhancement. Condylar deformity was observed in 33 % of our patients, which is in accordance with some studies [ 16 , 31 ] while others reported higher rates [ 8 ] with numbers increasing over time [ 17 ].…”

Section: Discussionsupporting

confidence: 92%

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Is early TMJ involvement in children with juvenile idiopathic arthritis clinically detectable? Clinical examination of the TMJ in comparison with contrast enhanced MRI in patients with juvenile idiopathic arthritis

et al. 2015

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BackgroundTo test clinical findings associated with early temporomandibular joint (TMJ) arthritis in comparison to the current gold standard contrast enhanced magnetic resonance imaging (MRI) in children with juvenile idiopathic arthritis (JIA).MethodsSeventy-six consecutive JIA patients were included in this study. Rheumatological and orthodontic examinations were performed blinded to MRI findings. Joint effusion and/or increased contrast enhancement of synovium or bone as well as TMJ deformity were assessed on MRI and compared to clinical findings. The maximal mouth opening capacity (MOC) of the JIA patients was compared to normative values obtained from a cohort of 20719 school children from Zürich, Switzerland.ResultsOn MRI a total of 54/76 (71 %) patients and 92/152 (61 %) joints had signs of TMJ involvement. MRI showed enhancement in 85/152 (56 %) and deformity in 39/152 (26 %) joints. MOC, asymmetry and restriction in condylar translation showed significant correlation to TMJ enhancement and deformity, whereas antegonial notching was correlated with TMJ deformity only. When joints with deformity were excluded, enhancement alone did not show a significant correlation with any clinical factor.ConclusionsClinical findings in affected TMJs are correlated with structural damage only. Therefore clinical assessment of TMJs does not allow to diagnose early arthritis accurately and will still depend on contrast enhanced MRI.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 92%

Is early TMJ involvement in children with juvenile idiopathic arthritis clinically detectable? Clinical examination of the TMJ in comparison with contrast enhanced MRI in patients with juvenile idiopathic arthritis

et al. 2015

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“…All joints can be affected in JIA including the Temporo Mandibular (TMJ). Involvement of the TMJ was first reported in 1897 by still when he described chronic arthritis in childhood [15]. The growth abnormality is described as and consists of condylar growth deviation, short ramus on the affected side, forming of a subangular notch, large gonial angle, large jaw angle and decreased vertical development of the posterior maxilla [4].…”

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confidence: 99%

Temporomandibular Joint Disorders in Children and Related Comorbidities

Dergin¹,

Aktop²

2014

J Arthritis

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Condyles are the growth centres of the mandible and growth of the mandible influences the overall shape of the face. In growing patients, trauma and pathology of the TMJ effect the condylar development, jaw function and the total morphology of face. In children with TMJ pathologies such as: JIA (Juvenile Idiopathic Arthritis), Hemifacial Microsomia, TMDs, Osteoarthritis, Condylar Fracture, condylar Trauma should be an essential part of the clinical examination and need longitudinal follow-up of used to predict the presence of TMJ related craniomandibular growth abnormalities. Periodic clinical examination of developing patients, early diagnosis and treatment of TMJ pathologies prevents further developmental, functional and esthetical problems in the future.

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“…Ir uzskats, ka klīniskie objektīvie simptomi ir samērā specifiski, bet nepietiekami sensitīvi TML artrītam(Koos et al, 2014). Mohameds un kolēģi apstiprina, ka klīniskie objektīvie simptomi atšķirībā no subjektīvajiem simptomiem spēcīgi korelē ar MRI atradi(Mohammed et al, 2012). citu pētījumu rezultāti, kas liecina, ka, pat kombinējot dažādus objektīvus simptomus un panākot salīdzinoši augstāku izmeklēšanas sensitivitāti, nav iespējams atklāt visus TML artrīta gadījumus, kurus apstiprina MRI atrade(Koos et al, 2014).…”

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Temporomandibulāro locītavu artrīta attīstību ietekmējošie faktori, klīniskie un radioloģiskie simptomi bērniem ar juvenilu idiopātisku artrītu. Promocijas darbs

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Juvenils idiopātisks artrīts (JIA) ir biežākā reimatoloģiskā slimība bērnu vecumā, kuras gadījumā iekaisums var skart jebkuru locītavu, tostarp arī temporomandibulārās locītavas (TML). Šo locītavu iekaisums var radīt ilgtermiņa sekas -dentofaciālus bojājumus un funkcionālus traucējumus, kas būtiski ietekmē pacienta dzīves kvalitāti. Zelta standarts temporomandibulāro locītavu artrīta diagnostikā ir magnētiskās rezonanses izmeklējums (MRI) ar kontrastvielu, kas ir invazīva, dārga metode. Lai noskaidrotu JIA slimnieku grupu, kuriem ir indikācijas MRI veikšanai, nepieciešams noskaidrot tos faktorus, kas ietekmē TML artrīta attīstību, kā arī zināt, kuri no subjektīvajiem un/vai objektīvajiem simptomiem biežāk asociējas ar artrīta atradi MRI. Darba mērķis bija noskaidrot TML artrīta attīstību ietekmējošos demogrāfiskos, slimību raksturojošos klīniskos, laboratoriskos un ģenētiskos faktorus, kā arī klīniskos (subjektīvos un objektīvos) un radioloģiskos simptomus un to savstarpējo saistību bērniem ar juvenilu idiopātisku artrītu. Pētījums bija prospektīvs, šķērsgriezuma, veidots no četrām daļām: 1) analizēti pacientu grupas demogrāfiskie un slimību raksturojošie rādītāji; 2) noteikti TML artrīta attīstību ietekmējošie faktori, tai skaitā HLA II klases alēles pacientu grupās ar TML artrīta pazīmēm MRI un bez tām; 3) analizēti subjektīvie un objektīvie simptomi un to saistība ar MRI; 4) analizēti MRI rezultāti un to atšķirības JIA pacientiem ar un bez TML artrīta subjektīvajiem un/vai objektīvajiem simptomiem. Pētījumā tika iekļauts 91 JIA pacients, kuriem laikā no 2010. līdz 2015. gadam veikts MRI ar kontrastvielu: 80 pacienti bija ar subjektīviem un/vai objektīviem TML artrīta simptomiem, bet 11 pacienti -bez simptomiem (asimptomātiski). TML artrīta attīstību ietekmējošie faktori, tai skaitā HLA II klases alēles, tika analizētas atkarībā no MRI atrades -72 pacientiem tika konstatētas TML artrīta pazīmes, 19 pacientiem to nebija. Pētījuma pacientiem un 100 veselu indivīdu kontroles grupai tika veikta HLA II klases alēļu DRB1, DQA1, DQB1 genotipēšana. Līdz šim nav veikti pētījumi par HLA II klases alēlēm JIA slimniekiem ar TML artrītu. No visiem demogrāfiskiem, slimību raksturojošiem klīniskiem un laboratoriskiem TML artrīta attīstību ietekmējošajiem faktoriem CRP bija statistiski ticami augstāks pacientu grupā ar artrīta MRI atradi. Tika konstatēts, ka JIA ar TML artrītu pastāv ģenētiska predispozīja. Risks TML artrīta attīstībai bija pacientiem ar alēlēm DRB1*07:01,

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Juvenile idiopathic arthritis and the temporomandibular joint

Cited by 9 publications

References 21 publications

Is early TMJ involvement in children with juvenile idiopathic arthritis clinically detectable? Clinical examination of the TMJ in comparison with contrast enhanced MRI in patients with juvenile idiopathic arthritis

Is early TMJ involvement in children with juvenile idiopathic arthritis clinically detectable? Clinical examination of the TMJ in comparison with contrast enhanced MRI in patients with juvenile idiopathic arthritis

Temporomandibular Joint Disorders in Children and Related Comorbidities

Temporomandibulāro locītavu artrīta attīstību ietekmējošie faktori, klīniskie un radioloģiskie simptomi bērniem ar juvenilu idiopātisku artrītu. Promocijas darbs

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