Early detection of temporomandibular joint arthritis in children with juvenile idiopathic arthritis – the role of contrast-enhanced MRI

Abstract

Given this considerable overlap of results in dynamic contrast-enhanced MRI, the degree of contrast enhancement alone did not allow differentiation between TMJs with and without signs of inflammation. Thickening of the soft joint tissue seems to remain the earliest sign to reliably indicate TMJ arthritis.

Optimization of Quantitative Dynamic Postgadolinium MRI Technique Using Normalized Ratios for the Evaluation of Temporomandibular Joint Synovitis in Patients with Juvenile Idiopathic Arthritis

“…R, the ratio of the postgadolinium T1 signal of the synovium to the postgadolinium T1 signal of the longus capitis, (one of the 3 normalized ratios used in this study), corresponds to the ratio previously published by Resnick et al 8 and Peacock et al 6 In these publications, a 1.55 threshold was proposed as a reliable discriminator between symptomatic JIA and control joints. 7,9 For each temporal sampling point, the relation of R, above or below, to the threshold 1.55 was recorded.…”

“…4 While many prior MR imaging approaches have relied on subjective interpretation of synovial enhancement more recently, attempts have been made to assess the utility of quantitative analysis of TMJ synovial enhancements. [5][6][7][8] Peacock et al 6 defined a ratio of the TMJ synovial postgadolinium signal inten-sity normalized to the longus capitis muscle in control patients and found a 95% specificity threshold of 1.55. Resnick et al 8 found that the 1.55 threshold had a 91% sensitivity and 96% specificity for detecting synovitis in symptomatic JIA TMJs.…”

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

“…It is a fact that MRI may detect TMJ arthritis in children with JIA without symptoms or clinical findings. However, contrast enhancement is also seen in healthy children and adolescents , and thus the reliability of contrast‐enhanced MRI to assess synovial inflammation is discussed , reflecting the complex diagnostics of the TMJ.…”

MR Imaging of the Temporomandibular Joint in Juvenile Idiopathic Arthritis: Technique and Findings

“…TMJ involvement in JIA is difficult to detect clinically (7). Moreover, the main growth center of the mandible is located in the condyle, separated from the joint space by only a thin layer of fibrocartilage (8).…”