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Article Summary
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Ringold S et al. - The presence of radiographic changes when the physician first suspected temporomandibular joint (TMJ) disease in 84% of JIA patients emphasizes the need for better screening and early intervention for synovitis in this joint. Methods- Aim was to describe the clinical and radiographic outcomes in JIA pts who underwent one or more intraarticular corticosteroid (IAS) injections w/o imaging guidance
- Retrospective chart review was performed for all JIA pts who underwent one or more IAS injections of their TMJ
- IAS injections were performed by the same oral and maxillofacial surgeon w/o imaging guidance, using either triamcinolone acetonide or triamcinolone hexacetonide
- The primary outcomes assessed were maximal incisal opening (MIO) measurements, patient-reported symptoms, physical examination findings, and imaging results
Results- 25 pts were identified
- 84% had radiographic evidence of TMJ disease when TMJ disease was first suspected by their physician
- The 25 pts underwent 74 IAS injections on 47 separate occasions
- When baseline MIO measurements were compared to the last MIO measurements of the study period, there was a mean increase in MIO of 6.9 mm
- There was a mean increase in MIO of 3.8 mm following each IAS injection
- Pts who underwent multiple IAS injections had a mean increase in MIO after first injection of 6.6 mm
- However, the mean increase in MIO after subsequent injections was 0.4 mm
- 1 patient developed sc atrophy at the injection site
- 2 pts developed small, asymptomatic intraarticular calcifications
- No additional adverse events were reported
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