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

Caruso, Paul; Buch, Karen; Rincon, Sandra; Hakimelahi, Reza; Resnick, Cory M.; Foster, Courtney; Guidoboni, L.; Donahue, Tammy L. Haut; Macdonald, Rainer; Rothermel, H.; Curtin, Hugh D.; Kaban, Leonard B.

doi:10.3174/ajnr.a5424

Cited by 10 publications

(3 citation statements)

References 7 publications

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“…Likewise, Ma et al [ 38 ] compared a metric that evaluated only the change in SI pre- versus post-administration of gadolinium with a metric that measured a signal to noise ratio based upon enhancement in surrounding tissue, studying 67 children with JIA and 24 non-arthritic controls. Consistent with the study by Caruso et al [ 37 ], Ma et al concluded that the ER, which incorporated the extent of enhancement in the surrounding tissue, was better able to discriminate JIA patients with mild disease from controls [ 38 ]. While the optimal method of assessing the extent of TMJ joint fluid or enhancement in controls may not be entirely clear, it is evident that small amounts of joint fluid and CE in non-arthritic subjects are common.…”

Section: Methodssupporting

confidence: 70%

“…These ratios were (postGadolinium SI in the TMJ – preGadolinium SI in the TMJ)/(postGadolinium SI in the longus capitus – preGadolinium SI in the longus capitus); (postGadolinium SI in the TMJ – preGadolinium SI in the TMJ)/(postGadolinium of longus capitus); and (postGadolinium SI of TMJ)/(postGadolinium SI of longus capitus). Of those three, they concluded that the most favorable measure was the second (postGadolinium SI in the TMJ – preGadolinium SI in the TMJ)/(postGadolinium of longus capitus), due to optimal discrimination among the three groups and a lack of a substantial increase over time [ 37 ]. Likewise, Ma et al [ 38 ] compared a metric that evaluated only the change in SI pre- versus post-administration of gadolinium with a metric that measured a signal to noise ratio based upon enhancement in surrounding tissue, studying 67 children with JIA and 24 non-arthritic controls.…”

Section: Methodsmentioning

confidence: 99%

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Temporomandibular joint arthritis in juvenile idiopathic arthritis, now what?

et al. 2018

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BackgroundArthritis involving the temporomandibular joint (TMJ) complicates 40 - 96% of cases of juvenile idiopathic arthritis (JIA), potentially leading to devastating changes to form and function. Optimal evaluation and management of this joint remains a matter of ongoing discussion.MethodsWe performed a PubMed search for all articles with keywords “temporomandibular” and “arthritis”, covering the dates 2002 through February 28, 2018. A separate PubMed search was performed for all articles with keywords “temporomandibular joint”, “arthritis”, and “treatment” covering the same dates.FindingsThe TMJ is a particularly challenging joint to assess, both clinically and with imaging studies. Clinical assessment of the TMJ is hampered by the low sensitivity of joint pain as well as the absence of physical exam findings early in the disease process. As with all joints, plain radiography and computed tomography only detect arthritic sequelae. Additionally, there is mixed data on the sensitivity of ultrasound, leaving magnetic resonance imaging (MRI) as the optimal diagnostic modality. However, several recent studies have shown that non-arthritic children can have subtle findings on MRI consistent with TMJ arthritis, such as joint effusion and contrast enhancement. Consequently, there has been an intense effort to identify features that can be used to differentiate mild TMJ arthritis from normal TMJs, such as the ratio of the enhancement within the TMJ itself compared to the enhancement in surrounding musculature. With respect to treatment of TMJ arthritis, there is minimal prospective data on medical therapy of this complicated joint. Retrospective studies have suggested that the response to medical therapy of the TMJ may lag behind that of other joints, prompting use of intraarticular (IA) therapy. Although most studies have shown short-term effectiveness of corticosteroids, the long-term safety of this therapy on local growth as well as on the development of IA heterotopic bone have prompted recommendations to limit use of IA corticosteroids. Severe TMJ disease from JIA can also be managed non-operatively with splints in a growing child, as well as with surgery.ConclusionIn this review, we summarize literature on the diagnosis and management of TMJ arthritis in JIA and suggest a diagnostic and therapeutic algorithm for children with refractory TMJ arthritis.

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Section: Methodssupporting

confidence: 70%

Section: Methodsmentioning

confidence: 99%

Temporomandibular joint arthritis in juvenile idiopathic arthritis, now what?

et al. 2018

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“…Changes in the TMJ score between repeat imaging of the same state of disease may be significant when the imaging parameters are not standardized, or the imaging interval is long enough to introduce physiological changes. Quantitative methods for scoring the degree of inflammation have demonstrated a high degree of discriminatory validity [ 26 , 27 ] but are also affected by temporal variations [ 28 ]. In a semiquantitative scoring system such as the JAMRIS-TMJ, these errors may be relatively low compared to the between-reader variance but should still be accounted for when using the scoring system in longitudinal evaluation.…”

Section: Discussionmentioning

confidence: 99%

Assessing the Reliability of the OMERACT Juvenile Idiopathic Arthritis Magnetic Resonance Scoring System for Temporomandibular Joints (JAMRIS-TMJ)

Tolend

Doria

Meyers

et al. 2021

JCM

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Contrast-enhanced magnetic resonance imaging (MRI) remains the most comprehensive modality to assess juvenile idiopathic arthritis (JIA)-related inflammation and osteochondral damage in the temporomandibular joints (TMJ). This study tested the reliability of a new JIA MRI scoring system for TMJ (JAMRIS-TMJ) and the impact of variations in calibration and reader specialty. Thirty-one MRI exams of bilateral TMJs were scored independently using the JAMRIS-TMJ by 20 readers consisting of radiologists and non-radiologist clinicians in three reading groups, with or without a calibrating atlas and/or tutorial. The inter-reader reliability in the multidisciplinary cohort assessed by the generalizability coefficient was 0.61–0.67 for the inflammatory and 0.66–0.74 for the damage domain. The atlas and tutorial did not improve agreement within radiologists, but improved the agreement between radiologist and non-radiologist groups. Agreements between different calibration levels were 0.02 to 0.08 lower by the generalizability coefficient compared to agreement within calibration levels; agreement between specialty groups was 0.04 to 0.10 lower than within specialty groups. Averaging two radiologists raised the reliability above 0.8 for both domains. Therefore, the reliability of JAMRIS-TMJ was moderate-to-good depending on the presence of specialty and calibration differences. The atlas and tutorial are necessary to improve reliability when the reader cohort consists of multiple specialties.

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