How important is early magnetic resonance imaging of the temporomandibular joint for the treatment of children with juvenile idiopathic arthritis: a retrospective analysis

Hauser, Raphael; Schroeder, S; Cannizzaro, Elvira; Müller, Lukas; Kellenberger, Christian J.; Saurenmann, Rotraud K.

doi:10.1186/1546-0096-12-36

Cited by 14 publications

(10 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Magnetic resonance imaging (MRI) has become the standard for assessing the temporomandibular joint in children with juvenile idiopathic arthritis because both joint inflammation and joint damage can be evaluated [ 1 , 2 ]. Contrast-enhanced MRI seems to remain the only method for reliably detecting early arthritis of the temporomandibular joint [ 3 – 7 ] and may directly impact treatment decisions [ 8 , 9 ]. For assessing and monitoring the course of arthritis, grading of the MRI findings is essential [ 10 – 13 ].…”

Section: Introductionmentioning

confidence: 99%

Temporomandibular joint atlas for detection and grading of juvenile idiopathic arthritis involvement by magnetic resonance imaging

et al. 2017

View full text Add to dashboard Cite

Contrast-enhanced magnetic resonance imaging (MRI) is considered the diagnostic standard for identifying involvement of the temporomandibular joint by juvenile idiopathic arthritis. Early or active arthritis is shown as bone marrow oedema, joint effusion, synovial thickening and increased joint enhancement. Subsequent joint damage includes characteristic deformity of the mandibular condyle, bone erosion, disk abnormalities and short mandibular ramus due to impaired growth. In this pictorial essay, we illustrate normal MRI findings and growth-related changes of the temporomandibular joint in children. The rationale and practical application of semiquantitative MRI assessment of joint inflammation and damage are discussed and presented. This atlas can serve as a reference for grading temporomandibular joint arthritis according to the scoring systems proposed by working groups of OMERACT (Outcome Measures in Rheumatology and Clinical Trials) and the EuroTMjoint research network. Systematic assessment of the level of inflammation, degree of osteochondral deformation, and growth of the mandibular ramus by MRI may aid in monitoring the course of temporomandibular joint arthritis and evaluating treatment options.Electronic supplementary materialThe online version of this article (10.1007/s00247-017-4000-0) contains supplementary material, which is available to authorized users.

show abstract

Section: Introductionmentioning

confidence: 99%

Temporomandibular joint atlas for detection and grading of juvenile idiopathic arthritis involvement by magnetic resonance imaging

et al. 2017

View full text Add to dashboard Cite

show abstract

“…Because joint swelling and other symptoms are seldom reported by patients, TMJ has been described as “the forgotten joint” and diagnostic imaging is considered mandatory to assess JIA involvement [ 3 ]. Contrast-enhanced magnetic resonance imaging (MRI) is considered the gold standard to reliably diagnose both acute TMJ arthritis and deformation of the TMJ and may have direct impact on treatment decisions [ 4 ]. Biomarkers of diseases are valuable tools for correct diagnosis and for evaluating appropriate treatment protocols.…”

Section: Introductionmentioning

confidence: 99%

“…Early TMJ MRI led to changes in the treatment in 62 % of patients with 60 patients getting additional joint injections and 9 patients getting systemic medication. Therefore, it is recommended to perform TMJ MRI in young children even if they require sedation, as they have an increased rate of TMJ involvement which can stay undetected during clinical examinations [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Contemporary management of TMJ involvement in JIA patients and its orofacial consequences

et al. 2016

View full text Add to dashboard Cite

Juvenile idiopathic arthritis is the most common chronic rheumatic condition during childhood. Temporomandibular joint arthritis is frequently asymptomatic. When it takes place during childhood, it may affect condylar growth; therefore, these children are at risk of unfavorable long-term outcomes from the associated joint damage. The etiology is not completely understood, but it is considered as multifactorial with both genetic and environmental factors involved.The standardized examination and imaging protocols serve important purpose to diagnose temporomandibular joint (TMJ) arthritis not only to establish an early interventional strategy but also to assess craniofacial growth and the progression of signs and symptoms in those patients. Although the treatment of juvenile idiopathic arthritis (JIA) has changed dramatically over the last decades due to new therapeutic options, TMJ arthritis still can develop during the course of the disease. In clinical experience, TMJs appear to respond less well to the standard of care used to treat other joints. More individualized approach to the patient’s treatment serves as the main goal of personalized medicine. It could be achieved by adopting new methods of medical imaging such as conebeam computer tomography as well as developing reliable biomarkers which may assist with predicting disease type, course, or severity and predicting response to medication.This article provides an overview of current information on orofacial complications in JIA and its management. Based on information provided in this review, more precise diagnosis, proper tools for recognizing people at risk, and more efficient treatment approaches could be implemented. This may lead to more personalized treatment management strategies of TMJ complications of JIA patients.

show abstract

“…Involvement of temporomandibular joints (TMJ) varies highly depending on the diagnostic methods used, the population and JIA subgroups studied, ranging from 17 % to 87 % [ 2 – 6 ]. Contrast enhanced magnetic resonance imaging (MRI) is considered the gold standard to reliably diagnose both acute TMJ arthritis and deformation of the TMJ [ 3 , 7 , 8 ] and may have direct impact on treatment decisions [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

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

View full text Add to dashboard Cite

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.

show abstract

How important is early magnetic resonance imaging of the temporomandibular joint for the treatment of children with juvenile idiopathic arthritis: a retrospective analysis

Cited by 14 publications

References 27 publications

Temporomandibular joint atlas for detection and grading of juvenile idiopathic arthritis involvement by magnetic resonance imaging

Temporomandibular joint atlas for detection and grading of juvenile idiopathic arthritis involvement by magnetic resonance imaging

Contemporary management of TMJ involvement in JIA patients and its orofacial consequences

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

Contact Info

Product

Resources

About