Rheumatology Medical News about JIA;temporomandibular joint involvement

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Early diagnosis of temporomandibular joint involvement in juvenile idiopathic arthritis: A pilot study comparing clinical examination and ultrasound to magnetic resonance imaging
Rheumatology, 04/24/09

Müller L et al. – Study reports that none of the methods tested was able to reliably predict the presence or absence of MRI-proven inflammation in the temporomandibular joint (TMJ) in juvenile idiopathic arthritis (JIA) pts. Ultrasound (US) was the least useful of all methods tested to exclude active TMJ arthritis.

Methods

Aim was to study the validity of both rheumatological and orthodontic examinations and US as screening methods for early diagnosis of TMJ arthritis against the gold standard MRI
30 JIA pts; rheumatological and orthodontic examinations, and US performed within 1 month of MRI
Joint effusion and/or increased contrast enhancement of synovium or bone were considered signs of active arthritis on MRI

Results

63% of pts and 55% joints had signs of TMJ involvement on MRI
This was associated with condylar deformity in 47% pts and 45% joints
Rheumatological, orthodontic and US examinations correctly diagnosed 58%, 47% and 33% pts, respectively, with active TMJ arthritis
However, it misdiagnosed 42%, 53% and 67% pts, respectively, as having no signs of inflammation
The best predictor for active arthritis on MRI was a reduced maximum mouth opening

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