Temporomandibular joint involvement in patients with Juvenile Idiopathic Arthritis: comparison of ultrasonography and magnetic resonance imaging in assessing the periarticular space width

Abstract

Objectives This study aimed to compare the performance of Ultrasonography (US) and Magnetic Resonance Imaging (MRI) in assessing the Lateral Periarticular Space (LPAS) of Temporomandibular Joints (TMJs) in patients with Juvenile Idiopathic Arthritis (JIA). Methods The LPAS width was evaluated in two different patient groups. In the JIA group, including 29 children (13 ± 2.8 years) with JIA, the LPAS width was measured with both MRI and US. In the healthy group, including 28 healthy children (12.6 ± 2.5 years), the LPAS width was measured only with US. Comparisons of LPAS width based on patient groups and TMJ contrast enhancement in MRI were evaluated by applying the Mann–Whitney U test. Correlation and agreement between MRI and US measurements in JIA group were tested using Spearman rank correlation and Bland–Altman method. Results The LPAS width was significantly greater in the JIA group than in the healthy group. In the JIA group, the LPAS width was significantly greater in TMJs with moderate/severe enhancement than those with mild enhancement. A positive significant correlation between MRI and US measurements of LPAS width was found in the JIA group. In the same group, Bland–Altman method showed a good level of agreement between MRI and US measurements. Conclusion Although, US cannot replace MRI in the evaluation of TMJ in patients with JIA, US could be used as a supplementary imaging method to MRI in assessing the TMJ disease.

Clinical and Instrumental Temporomandibular Joint Evaluation in Children and Adolescents with Juvenile Idiopathic Arthritis: A Medium-Term Follow-Up

“…From a muscular point of view, myalgia in the head and neck muscles may occur due to untreated TMJ involvement; pain mainly occurs during mouth opening and mastication, mainly in the articular area and in the masseter area [18][19][20][21]. Early detection of TMJ disorders in JIA patients is crucial to prevent future facial growth and dental problems, moderate the TMJ damage, and increase the patients' quality of life [22]. Diagnostic steps include collecting patient history, analyzing TMJ and masticatory muscle function, and using magnetic resonance imaging (MRI) to confirm joint involvement during the active inflammatory phase [23,24].…”

“…However, the former occurs in patients over the age of sixteen, while the latter is a pathology that mainly affects bone tissue in which inflammation of the TMJ arises as a secondary symptom in a limited circle of cases [27][28][29]. Since early detection of TMJ involvement and continued follow-up can be useful to improve the patient's general condition, this observational study was carried out [22]. The study's objective is to determine if clinical and instrumental parameters obtained through muscle palpation and electromyographic examination can serve as reliable, non-invasive functional prognostic indicators of potential TMJ involvement in JIA patients.…”