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

Navallas, María; Inarejos, Emilio; Iglesias, E.; Lee, Gui Youn Cho; Rodríguez, Natalia Pérez; Antón, Jordi

doi:10.1148/rg.2017160078

“…Systemische Manifestationen von entzündlichen Erkrankungen können bei granulomatösen Prozessen wie Sarkoidose, rheumatoider Arthritis und juveniler idiopathischer Arthritis zu beobachten sein [85]. Dabei bilden sich Granulome aus Entzündungszellen oder Makrophagen mit peripheren Lymphozyten [86,87]. Auch Autoimmunkrankheiten wie Psoriasisarthritis und Sklerodermie können mit maxillofazialen Anomalien einhergehen [88].…”

Section: Entzündliche Erkrankungenunclassified

Kraniofaziale Manifestationen von systemischen Erkrankungen: CT- und MRT-Befunde

Arasa¹,

Chapman²,

Kuno³

et al. 2019

Neuroradiol Scan

0

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Many systemic diseases or conditions can affect the maxillofacial bones; however, they are often overlooked or incidentally found at routine brain or head and neck imaging performed for other reasons. Early identification of some conditions may significantly affect patient care and alter outcomes. Early recognition of nonneoplastic hematologic disorders, such as thalassemia and sickle cell disease, may help initiate earlier treatment and prevent serious complications. The management of neoplastic diseases such as lymphoma, leukemia, or Langerhans cell histiocytosis may be different if diagnosed early, and metastases to the maxillofacial bones may be the first manifestation of an otherwise occult neoplasm. Endocrinologic and metabolic disorders also may manifest with maxillofacial conditions. Earlier recognition of osteoporosis may alter treatment and prevent complications such as insufficiency fractures, and identification of acromegaly may lead to surgical treatment if there is an underlying growth hormone-producing adenoma. Bone dysplasias sometimes are associated with skull base foraminal narrowing and subsequent involvement of the cranial nerves. Inflammatory processes such as rheumatoid arthritis and sarcoidosis may affect the maxillofacial bones, skull base, and temporomandibular joints. Radiologists should be familiar with the maxillofacial computed tomographic and magnetic resonance imaging findings of common systemic disorders because these may be the first manifestations of an otherwise unrevealed systemic process with potential for serious complications.

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“…Systemic manifestations of inflammatory disorders are seen in granulomatous processes such as sarcoidosis, rheumatoid arthritis, and juvenile idiopathic arthritis (85,86), where there is formation of granulomas with inflammatory cells or macrophages surrounded by lymphocytes (87). Other autoimmune diseases such as psoriatic arthritis and scleroderma may manifest with maxillofacial abnormalities (88).…”

Section: Inflammatory Disordersmentioning

confidence: 99%

Craniofacial Manifestations of Systemic Disorders: CT and MR Imaging Findings and Imaging Approach

Arasa

¹

,

Chapman

²

,

Kuno

³

et al. 2018

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Many systemic diseases or conditions can affect the maxillofacial bones; however, they are often overlooked or incidentally found at routine brain or head and neck imaging performed for other reasons. Early identification of some conditions may significantly affect patient care and alter outcomes. Early recognition of nonneoplastic hematologic disorders, such as thalassemia and sickle cell disease, may help initiate earlier treatment and prevent serious complications. The management of neoplastic diseases such as lymphoma, leukemia, or Langerhans cell histiocytosis may be different if diagnosed early, and metastases to the maxillofacial bones may be the first manifestation of an otherwise occult neoplasm. Endocrinologic and metabolic disorders also may manifest with maxillofacial conditions. Earlier recognition of osteoporosis may alter treatment and prevent complications such as insufficiency fractures, and identification of acromegaly may lead to surgical treatment if there is an underlying growth hormone-producing adenoma. Bone dysplasias sometimes are associated with skull base foraminal narrowing and subsequent involvement of the cranial nerves. Inflammatory processes such as rheumatoid arthritis and sarcoidosis may affect the maxillofacial bones, skull base, and temporomandibular joints. Radiologists should be familiar with the maxillofacial computed tomographic and magnetic resonance imaging findings of common systemic disorders because these may be the first manifestations of an otherwise unrevealed systemic process with potential for serious complications. Online supplemental material is available for this article. RSNA, 2018.

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“…12 In RA patients, the degree of arthritis is assessed through conventional radiography, cone beam multi-slice computed tomography (CBCT or MSCT), and magnetic resonance imaging (MRI). 1,13,14 The dose of X-ray delivered during CBCT is low, which is advantageous for exploring TMJ in children, and enables high spatial resolution with limited irradiation levels. [15][16][17][18] The advantage of CBCT is the visualization of dense structures, such as the temporal bone and mandibular condyle, in three dimensions.…”

Section: Introductionmentioning

confidence: 99%

“…Magnetic resonance imaging seems to be the most relevant imaging modality for assessing TMJ osteoarthritis, as early changes can be detected, and both hard and soft tissues and even joint fluid can be visualized. 13,19 Gradient-echo T1 sequences enable evaluation of bone changes, while gradient-echo T2 sequences are mainly used to analyze less dense structures such as cartilage, joint disc, or synovial fluid in the upper and lower joint cavities. 20 The aim of this study was to describe TMJ inflammation and damage in an arthritis mouse model in comparison with that in healthy controls by using histological and imaging techniques already used in clinical practice.…”

Section: Introductionmentioning

confidence: 99%

Temporomandibular joint damage in K/BxN arthritic mice

Kuchler‐Bopp

¹

,

Mariotte

²

,

Strub

³

et al. 2020

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Rheumatoid arthritis (RA) is an autoimmune disease affecting 1% of the world population and is characterized by chronic inflammation of the joints sometimes accompanied by extra-articular manifestations. K/BxN mice, originally described in 1996 as a model of polyarthritis, exhibit knee joint alterations. The aim of this study was to describe temporomandibular joint (TMJ) inflammation and damage in these mice. We used relevant imaging modalities, such as micro-magnetic resonance imaging (μMRI) and micro-computed tomography (μCT), as well as histology and immunofluorescence techniques to detect TMJ alterations in this mouse model. Histology and immunofluorescence for Col-I, Col-II, and aggrecan showed cartilage damage in the TMJ of K/BxN animals, which was also evidenced by μCT but was less pronounced than that seen in the knee joints. μMRI observations suggested an increased volume of the upper articular cavity, an indicator of an inflammatory process. Fibroblast-like synoviocytes (FLSs) isolated from the TMJ of K/BxN mice secreted inflammatory cytokines (IL-6 and IL-1β) and expressed degradative mediators such as matrix metalloproteinases (MMPs). K/BxN mice represent an attractive model for describing and investigating spontaneous damage to the TMJ, a painful disorder in humans with an etiology that is still poorly understood.

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

Cited by 44 publications

References 51 publications

Kraniofaziale Manifestationen von systemischen Erkrankungen: CT- und MRT-Befunde

Kraniofaziale Manifestationen von systemischen Erkrankungen: CT- und MRT-Befunde

Craniofacial Manifestations of Systemic Disorders: CT and MR Imaging Findings and Imaging Approach

Temporomandibular joint damage in K/BxN arthritic mice

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