Disk abnormality coexists with any degree of synovial and osseous abnormality in the temporomandibular joints of children with juvenile idiopathic arthritis

Abstract

Disk abnormalities were frequent. Disk displacement also occurred in joints with early temporomandibular joint arthritis, i.e., with normal bone shape. Other disk abnormalities were found in joints with bone abnormalities. Attention should be paid to disk abnormalities both in early and long-standing temporomandibular joint arthritis in children with juvenile idiopathic arthritis.

Temporomandibular Joint Involvement in Association With Quality of Life, Disability, and High Disease Activity in Juvenile Idiopathic Arthritis

“…We are not aware of any TMJ studies in children with JIA that have used this general definition of arthritis. In line with other studies , clinical TMJ involvement (whether active or not) in our study was based on the presence of TMJ pain and/or LOM. The observed low frequency of clinical TMJ involvement was therefore not surprising.…”

Temporomandibular joint involvement in childhood arthritis: comparison of ultrasonography-assessed capsular width and MRI-assessed synovitis

“…In a recent MRI study, no TMJs in children with JIA had effusion without synovial thickening. 18 The ultrasonography image is limited to the lateral part of the joint, and a joint with focal medial synovitis may have a normal capsular width. A laterally or medially displaced disc may result in an altered capsular width at the condylar level.…”

“…Recently, we showed that 78% of children with JIA and TMJ symptoms had evidence of synovitis on MRI. 18 MRI should be performed prior to injection therapy of the TMJ, since there are obvious pitfalls with the ultrasonography examination.…”

“…Ultrasonography examinations were performed on Philips HDI 5000 (Philips, Eindhoven, Netherlands), Philips iU22 (Philips) or Siemens S3000Ô (Siemens, Erlangen, Germany) with high-frequency linear probes (12)(13)(14)(15)(16)(17)(18). Two experienced musculoskeletal radiologists (EK and RBG), aware of age and gender, analyzed the ultrasonography images separately, blinded to the MRI observations.…”

“…The amount of synovitis was registered using a one to three grading scale: grade 1 (slight synovitis): slight synovial thickening more than dots or lines; grade 2 (moderate synovitis): moderate band-like thickening including slight distension of the joint space; and grade 3 (extensive synovitis): extensive thickening with extensive distension of the joint space. 18 The continuous variables age at examination, age at symptom onset, age at disease onset (doctor's diagnosis), disease duration and ultrasonography capsular width were normally distributed and described by mean and standard deviation (SD). Numbers of active joints were described by median and quartiles.…”