Incidence of temporomandibular involvement in juvenile idiopathic arthritis

Twilt, Marinka; Arends, Lidia R.; Cate, Rebecca ten; Suijlekom-Smit, Lisette W. A. van

doi:10.1080/03009740601154368

Cited by 117 publications

(220 citation statements)

References 9 publications

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“…According to the ILAR revised criteria for the classification of JIA [1], 6 months after onset, 11 out of 68 children had extended oligoarthritis. ANOVA was used to assess correlations between US findings and ESR, CRP levels, and antinuclear (ANA) antibody titers.…”

Section: Patients and Controlsmentioning

confidence: 99%

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Sonographic evaluation of the temporomandibular joints in juvenile idiopathic arthritis

Melchiorre

Falcini

Kaloudi

et al. 2010

Journal of Ultrasound

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KEYWORDSUltrasonography; TMJ; Oligo-articular onset; Early JIA.Abstract Introduction: Juvenile idiopathic arthritis (JIA) may cause damage to the temporomandibular joint (TMJ). In oligoarticular forms of JIA, TMJ involvement is often asymptomatic and consequently overlooked. The aim of this study was to evaluate the presence of TMJ joint effusion (JE) by ultrasonography (US) in patients with early arthritis. Materials and methods: We examined 68 children (57 girls, 11 boys, age range 9.1e16.0 years, mean age 11.0 years) recently diagnosed with JIA. None had received any specific treatment for inflammation. Symptomatic TMJ involvement was diagnosed when one or more of the following were present: 1) recurrent pain (spontaneous or on movement of the jaw); 2) crepitation; 3) feeling of stiffness or fatigue of the jaw; 4) intermittent locking. US of the TMJ was performed in static and dynamic phases with a General Electric LOGIQ7 scanner and a linear transducer (8.5 MHz) positioned along the axis of the mandibular ramus. JE was diagnosed when the joint capsule was !1.5 mm thick. Results: Forty-six out (68%) of 68 children had US evidence of TMJ effusions (bilateral in 16 [35%] cases), but only 2/46 were symptomatic. Conclusions: These data suggest that children with early stage oligoarticular JIA children are likely to have inflammation of the TMJs even in the absence of symptoms. US is a simpleto-use, noninvasive, radiation-free tool that can provide useful information in the assessment and follow-up of TMJ involvement in children and young adults with JIA.Sommario Introduzione: L'artrite Idiopatica giovanile (AIG) determina alterazioni a carico della testa condilare dell'articolazione temporomandibolare (ATM). Nell'esordio oligoarticolare (OA) l'interessamento dell'ATM viene spesso trascurato perchè può essere asintomatico. Lo scopo di questo studio è quello di valutare la presenza di versamento intrarticolare (V) dell'ATM, mediante esame ecografico (US), nelle fasi precoci di malattia. Materiale e metodi: Sono stati studiati 68 bambini (57 bambine e 11 bambini, di età compresa tra 9,1 e 16, anni, età media: 11,02 AE 4,2 mesi) con AIG ad esordio OA. I pazienti (pz) erano sintomatici quando uno dei quattro sintomi seguenti era presente: 1) dolore ricorrente (a riposo o durante il movimento di apertura della bocca); 2) presenza di scrosci articolari; 3) presenza di limitazione nell'apertura della bocca; 4) locking intermittente. US è stato eseguito su entrambe le ATM sia in fase statica che dinamica, mediante ecografo General Electric (LOGIQ7) con sonda lineare (8,5 MHz) posizionata lungo l'asse maggiore del ramo condilare. Il V era presente quando lo spessore della capsula articolare era !1,5 mm. Risultati: 46/68 (68%) hanno presentato V a carico delle ATM; in 16 (35%) il V era bilaterale. 2/46 con V erano sintomatici, mentre in 44 non erano presenti sintomi. Conclusioni: Questi dati suggeriscono che un'alta percentuale di bambini e giovani adulti con AIG ad esordio OA, nella fase iniziale della malattia, presenta u...

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Section: Patients and Controlsmentioning

confidence: 99%

“…JIA is a chronic inflammatory disease that develops for the age of 16 years and persists for more than 6 weeks [1]. It is diagnosed according to criteria established in 1997 in Durban by the International League of Associations for Rheumatology (ILAR) and revised in 2001 in Edmonton [2].…”

Section: Introductionmentioning

confidence: 99%

Sonographic evaluation of the temporomandibular joints in juvenile idiopathic arthritis

Melchiorre

Falcini

Kaloudi

et al. 2010

Journal of Ultrasound

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“…Twenty-five percent of the patients with JIA have alterations in TMJ. These patients present destruction of articular structures, which can lead to typical facial expressions (10), such as the "bird face" (6). This can result in facial deformity such as asymmetry, micro and retrognathia (9), hypoplasy of the mandibular condyle, and consequent class II malocclusion, anterior open bite (4) and increased overjet (10).…”

Section: Introductionmentioning

confidence: 99%

“…The destruction of fibrocartilage induced by arthritis can lead to significant limitation of mandibular growth and development (2,6,8,9). Twenty-five percent of the patients with JIA have alterations in TMJ.…”

Section: Introductionmentioning

confidence: 99%

“…JIA represents a heterogeneous group of chronic inflammatory arthritis, and no specific term is universally accepted to classify the disease. The most recent terminology was presented in the Classification Taskforce of the Pediatric Standing Committee of the International League of Associations for Rheumatology (ILAR), proposed in 1994, in Santiago, Chile, and revised in 1997, in Durban, South Africa (6). ILAR aimed to create a classification model to divide children with chronic arthritis into homogeneous subtypes, providing a better understanding of the main causes of the disease and making easier the communication between researchers and professionals around the world.…”

Section: Introductionmentioning

confidence: 99%

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Juvenile idiopathic arthritis with involvement of the temporomandibular joint: the role of image examinations

Effio

Fernandes²,

Dutra

et al. 2010

Rev. odonto ciênc. (Online)

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Purpose: Juvenile idiopathic arthritis (JIA) has unknown etiology, and the involvement of the temporomandibular joint (TMJ) is rare in the early phase of the disease. The present article describes the use of computed tomography (CT) and magnetic resonance (MRI) images for the diagnosis of affected TMJ in JIA.Case description: A 12-year-old, female, Caucasian patient, with systemic rheumathoid arthritis and involvement of multiple joints was referred to the Imaging Center for TMJ assessment. The patient reported TMJ pain and limited opening of the mouth. The helical CT examination of the TMJ region showed asymmetric mandibular condyles, erosion of the right condyle and osteophyte-like formation. The MRI examination showed erosion of the right mandibular condyle, osteophytes, displacement without reduction and disruption of the articular disc.Conclusion: The disorders of the TMJ as a consequence of JIA must be carefully assessed by modern imaging methods such as CT and MRI. CT is very useful for the evaluation of discrete bone changes, which are not identified by conventional radiographs in the early phase of JIA. MRI allows the evaluation of soft tissues, the identification of acute articular inflammation and the differentiation between pannus and synovial hypertrophy.Key words: Juvenile idiopathic arthritis; temporomandibular joint; computed tomography; magnetic resonance imaging ResumoObjetivo: A artrite idiopática juvenil (AIJ) tem etiologia desconhecida e o envolvimento da articulação temporomandibular (ATM) é raro no estágio inicial da doença. Este artigo descreve o uso de imagens de tomografia computadorizada (TC) e de ressonância magnética (RM) para o diagnóstico de ATM afetada pela AIJ.Descrição do caso: Uma paciente de 12 anos de idade, leucoderma, portadora de AIJ com envolvimento de múltiplas articulações foi encaminhada ao Centro de Imaginologia para avaliação das ATMs. A paciente relatou dor na ATM e limitação de abertura bucal. O exame com TC helicoidal da região da ATM com reconstruções a 1 mm mostrou assimetria entre os côndilos mandibulares, erosão do côndilo direito e formação osteofítica. O exame de RM mostrou erosão do côndilo mandibular direito, osteófito, deslocamento sem redução e ruptura do disco articular.Conclusão: As desordens de ATM devido à AIJ devem ser cuidadosamente examinadas por modernas técnicas de imagem. A TC é muito útil para a detecção e avaliação de estruturas ósseas da ATM e permite o exame de alterações ósseas discretas, que não seriam identificadas por radiografias convencionais nas fases iniciais de AIJ. A RM permite a avaliação de tecidos moles, identificação de inflamação articular aguda e diferenciação entre hipertrofia sinovial e do pannus. Palavras

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Otogenic Temporomandibular Arthritis in Children

Burgess

Celerier

Breton

et al. 2017

JAMA Otolaryngol Head Neck Surg

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Incidence of temporomandibular involvement in juvenile idiopathic arthritis

Abstract: Condylar lesions due to arthritis can improve over time, indicating a regenerative capacity of the mandibular condyle. As condylar improvement seems to be associated with low disease activity, it is important to consider the TMJ when deciding on a therapeutic regimen.

Cited by 117 publications

References 9 publications

Sonographic evaluation of the temporomandibular joints in juvenile idiopathic arthritis

Sonographic evaluation of the temporomandibular joints in juvenile idiopathic arthritis

Juvenile idiopathic arthritis with involvement of the temporomandibular joint: the role of image examinations

Otogenic Temporomandibular Arthritis in Children

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