Reliability of Clinical Symptoms in Diagnosing Temporomandibular Joint Arthritis in Juvenile Idiopathic Arthritis

Koos, Bernd; Twilt, Marinka; Kyank, Ullrike; Fischer-Brandies, H; Gaßling, Volker; Tzaribachev, Nikolay

doi:10.3899/jrheum.131337

Cited by 74 publications

(80 citation statements)

References 34 publications

(33 reference statements)

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“…The TMJ is among the most frequently affected joint in JIA patients. Prevalence of TMJ damage has been reported to be 30%‐87%, depending on diagnostic criteria and on methodology . Although TMJ damage in JIA is frequently asymptomatic, this joint may be affected both uni‐ and bilaterally, may be the first joint affected or may be affected during the course of JIA …”

Section: Introductionmentioning

confidence: 99%

Temporomandibular joint damage in juvenile idiopathic arthritis: Diagnostic validity of diagnostic criteria for temporomandibular disorders

Rongo

Alstergren

Ammendola

et al. 2019

J of Oral Rehabilitation

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Summary Background Diagnostic criteria reported in the expanded taxonomy for temporomandibular disorders include a standardised clinical examination and diagnosis (DC/TMD 3.B) of temporomandibular joint (TMJ) damage in patients with juvenile idiopathic arthritis (JIA); however, their validity is unknown. Objectives To assess the validity of DC/TMD 3.B for the identification of TMJ damage in JIA‐patients, using magnetic resonance imaging (MRI) as gold standard, and to investigate the relation between clinical findings and TMJ damage. Methods Fifty consecutive JIA patients (9‐16 years) were recruited. DC/TMD 3.B were compared with TMJs MRI (100 TMJs) performed maximum at 1 month from the visit. The severity of TMJ damage was scored in four grades. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), logistic regression models with odds ratio of DC/TMD 3.B and clinical findings respect to MRI were calculated. Results The DC/TMD 3.B were inadequate in the identification of TMJ damage (sensitivity = 0.15, specificity = 0.92, PPV = 0.85, NPV = 0.28, P = 0.350). Chin deviation and TMJ crepitus were associated with worse TMJ damage (P = 0.006; P = 0.034). Reduced mouth opening (OR = 3.91, P = 0.039) and chin deviation (OR = 13.7, P = 0.014) were associated with the presence of TMJ damage. Combining “pain” (history of pain, TMJ pain, pain during movements) and “function” (TMJ crepitus, reduced mouth opening, chin deviation) clinical findings, the sensitivity and the specificity were 0.88 and 0.54. Conclusion DC/TMD 3.B present a low sensitivity to diagnose TMJ damage. Chin deviation, reduced mouth opening and TMJ crepitus are associated with TMJ damage. We suggest combining “pain” and “function” findings for the evaluation of TMJ damage in JIA patients.

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Section: Introductionmentioning

confidence: 99%

Temporomandibular joint damage in juvenile idiopathic arthritis: Diagnostic validity of diagnostic criteria for temporomandibular disorders

Rongo

Alstergren

Ammendola

et al. 2019

J of Oral Rehabilitation

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“…29 In contrast, routine MRI is of less clinical value in patients with TMJ arthritis-related signs and symptoms, since only a limited association is shown between orofacial symptoms and TMJ MRI findings. 20,[30][31][32][33] Supporting this, Arabshahi et al 31 found no association between clinical improvements in maximal mouth-opening capacity and resolution of MRI effusion at follow-up after TMJ arthritis treatment with intra-articular steroid injections. From a clinical point of view, this means that patients with TMJ arthritis-related orofacial signs and symptoms may present no MRI indications of TMJ inflammation.…”

Section: Stoustrup and Koosmentioning

confidence: 91%

Clinical craniofacial examination of patients with juvenile idiopathic arthritis

Stoustrup

Koos²

2015

Seminars in Orthodontics

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“…In this issue of The Journal, Koos, et al present results of their study about development of a clinical score for diagnosis of TMJ arthritis in patients with JIA 13 . The score is based on 5 well-defined clinical items, which were tested as single items as well as in all possible combinations.…”

Section: Rheumatologymentioning

confidence: 99%

Clinical Diagnosis of Temporomandibular Joint Arthritis: A Difficult Task

Saurenmann

2014

J Rheumatol

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Reliability of Clinical Symptoms in Diagnosing Temporomandibular Joint Arthritis in Juvenile Idiopathic Arthritis

Cited by 74 publications

References 34 publications

Temporomandibular joint damage in juvenile idiopathic arthritis: Diagnostic validity of diagnostic criteria for temporomandibular disorders

Temporomandibular joint damage in juvenile idiopathic arthritis: Diagnostic validity of diagnostic criteria for temporomandibular disorders

Clinical craniofacial examination of patients with juvenile idiopathic arthritis

Clinical Diagnosis of Temporomandibular Joint Arthritis: A Difficult Task

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