TMJ imaging in JIA patients—An overview

Larheim, Tore A.; Doria, A.; Kirkhus, Eva; Parra, Dimitri A.; Kellenberger, Christian J.; Arvidsson, Linda Z.

doi:10.1053/j.sodo.2015.02.006

Cited by 34 publications

(32 citation statements)

References 74 publications

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“…Inflammatory changes have previously been observed in TMJs with internal derangement by histology and could not be distinguished from those in TMJs with rheumatic arthritis . As in our patients with ADD, evidence of joint effusion on MRI and increased contrast enhancement have been associated with joint pain in TMJs with internal derangement, while surprisingly TMJ arthritis in JIA may often be asymptomatic . The inflammatory findings detected on MRI of TMJs with ADD included increased contrast enhancement, joint effusion, synovial thickening and bone marrow oedema, which were the same as described for TMJ arthritis in JIA .…”

Section: Discussionsupporting

confidence: 60%

“…In childhood, juvenile idiopathic arthritis (JIA) is the most common rheumatic disease affecting approximately 1 of 1000 children worldwide, with an increased risk for children with European descent and predilection for girls . The TMJ is involved in about half of JIA patients, with a large variation of the reported frequencies depending on the study population, diagnostic modality and diagnostic criteria . As TMJ involvement may be clinically inapparent, detection of early TMJ arthritis relies on contrast‐enhanced MRI showing signs of inflammation .…”

Section: Introductionmentioning

confidence: 99%

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Temporomandibular joint magnetic resonance imaging findings in adolescents with anterior disk displacement compared to those with juvenile idiopathic arthritis

Kellenberger

Bucheli

Schroeder-Kohler

et al. 2018

J of Oral Rehabilitation

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Background: Deformation of the mandibular condyle can be associated with anterior disk displacement (ADD) or involvement of the temporomandibular joint (TMJ) by juvenile idiopathic arthritis (JIA). Diagnostic differentiation is critical for proper management. Objectives:To compare morphology and inflammation between TMJs with ADD and JIA.Methods: Retrospective assessment of contrast-enhanced TMJ MRI in 18 adolescents (15 female, mean age 15.1 ± 1.9 years) with ADD and age-and gender-matched patients with JIA. Articular disk findings, inflammatory signs and osseous morphology were compared. Results:In the ADD group, 31 of 36 disks were displaced. In total, 28 of 31 displaced disks showed thickening of the bilaminar zone. In JIA patients, the disks were mainly flattened (19/36), centrally perforated (12/36) and/or anteriorly displaced (2/36). In total, 19 of 31 TMJs with ADD showed various degrees of inflammation, with joint effusion, synovial thickening and joint enhancement not significantly different from JIA patients. Osseous deformity was present in 27 of 31 TMJs with ADD, with frequent erosions in both groups (ADD 25/31; JIA 32/36, P = 0.55) but lower grades of condylar and temporal bone flattening than in JIA (P ≤ 0.001). Glenoid fossa depth was preserved in 28 of 31 joints with ADD and decreased in 26 of 36 joints with JIA (P < 0.0001). Mandibular ramus height was decreased in both groups. Conclusion:In adolescents, inflammatory signs are common MRI findings in symptomatic TMJs with ADD and thus should not be considered diagnostic for JIA involvement. In this cohort, both entities had high rates of condylar deformity, while TMJs with ADD showed a better-preserved and often normal shape of the glenoid fossa. K E Y W O R D S differential diagnosis, female adolescents, juvenile arthritis, magnetic resonance imaging, temporomandibular articular disk, temporomandibular joint diseases | 15 KELLENBERGER Et aL.

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Section: Discussionsupporting

confidence: 60%

Section: Introductionmentioning

confidence: 99%

Temporomandibular joint magnetic resonance imaging findings in adolescents with anterior disk displacement compared to those with juvenile idiopathic arthritis

Kellenberger

Bucheli

Schroeder-Kohler

et al. 2018

J of Oral Rehabilitation

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“…Juvenile idiopathic arthritis (JIA) is the most frequent cause of chronic inflammatory arthritis in childhood, with a prevalence of approximately 1 in 1,000 children . Inflammation, structural changes, or joint damage in the temporomandibular joint (TMJ) observable with magnetic resonance imaging (MRI) may occur in 40–90% of patients with JIA, depending on the subpopulation examined and the interpretation of the images . However, these changes often develop silently without symptoms, and irreversible facial deformities and functional impairments can be present by the time clinical symptoms appear .…”

Section: Introductionmentioning

confidence: 99%

Toward Establishing a Standardized Magnetic Resonance Imaging Scoring System for Temporomandibular Joints in Juvenile Idiopathic Arthritis

Tolend

Twilt

Cron

et al. 2018

Arthritis Care & Research

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“…72,73 Most large studies of children with JIA indicate that nearly half of the children will have radiographical TMJ abnormalities, although MRI studies with fewer patients have shown much higher frequencies. 74 The joints are characterized by deformation and may show a highly variable morphology. 44 Flattening of the condyle and fossa/eminence and widening of the fossa as well as the condyle anteroposteriorly Erosions may be present in active periods of the disease but should not be confused with non-homogeneous and non-compact cortex of the condyle seen in healthy growing children.…”

Section: Juvenile Idiopathic Arthritismentioning

confidence: 99%

Temporomandibular joint diagnostics using CBCT

Ak²,

Kristensen³

et al. 2015

Dentomaxillofacial Radiology

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128

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The present review will give an update on temporomandibular joint (TMJ) imaging using CBCT. It will focus on diagnostic accuracy and the value of CBCT compared with other imaging modalities for the evaluation of TMJs in different categories of patients; osteoarthritis (OA), juvenile OA, rheumatoid arthritis and related joint diseases, juvenile idiopathic arthritis and other intra-articular conditions. Finally, sections on other aspects of CBCT research related to the TMJ, clinical decision-making and concluding remarks are added. CBCT has emerged as a cost-and dose-effective imaging modality for the diagnostic assessment of a variety of TMJ conditions. The imaging modality has been found to be superior to conventional radiographical examinations as well as MRI in assessment of the TMJ. However, it should be emphasized that the diagnostic information obtained is limited to the morphology of the osseous joint components, cortical bone integrity and subcortical bone destruction/production. For evaluation of soft-tissue abnormalities, MRI is mandatory. There is an obvious need for research on the impact of CBCT examinations on patient outcome.

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TMJ imaging in JIA patients—An overview

Cited by 34 publications

References 74 publications

Temporomandibular joint magnetic resonance imaging findings in adolescents with anterior disk displacement compared to those with juvenile idiopathic arthritis

Temporomandibular joint magnetic resonance imaging findings in adolescents with anterior disk displacement compared to those with juvenile idiopathic arthritis

Toward Establishing a Standardized Magnetic Resonance Imaging Scoring System for Temporomandibular Joints in Juvenile Idiopathic Arthritis

Temporomandibular joint diagnostics using CBCT

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