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Magnetic Resonance Imaging Follow-up of Temporomandibular Joint Inflammation, Deformation and Mandibular Growth in Juvenile Idiopathic Arthritis Patients on Systemic Treatment


Bollhalder, Andrea; Patcas, Raphael; Eichenberger, Martina; Müller, Lukas; Schroeder-Kohler, Silke; Saurenmann, Rotraud Katharina; Kellenberger, Christian Johannes (2020). Magnetic Resonance Imaging Follow-up of Temporomandibular Joint Inflammation, Deformation and Mandibular Growth in Juvenile Idiopathic Arthritis Patients on Systemic Treatment. Journal of Rheumatology, 47(6):909-916.

Abstract

OBJECTIVE

To investigate the course of temporomandibular joint (TMJ) inflammation, osseous deformation and mandibular ramus growth in children with juvenile idiopathic arthritis (JIA) during systemic therapy.

METHODS

Longitudinal study of 38 consecutive JIA patients (29 female, median age 9.0 years, interquartile range 6.2 to 10.7 years) on systemic therapy with TMJ involvement, with two TMJ magnetic resonance imaging (MRI) examinations ≥ 2 years apart and no TMJ corticosteroid injection. Clinical and MRI findings were compared between initial and follow-up examinations and between TMJs with and without active inflammation at baseline.

RESULTS

Over a median period of 3.6 years (range, 2.0-8.7 years), MRI grade of TMJ inflammation improved (p=0.009) and overall osseous deformity tended to become less severe (p=0.114). In TMJs with arthritis at baseline (46 TMJs), both the grades of inflammation (p<0.001) and deformity (p=0.011) improved. In TMJs with no arthritis at baseline (30 TMJs), the frequency and grade of condylar deformation remained stable. Mandibular ramus growth rates were not significantly different between TMJs with and without arthritis at baseline (1.3 mm/year versus 1.5 mm/year, p=0.273), and were not correlated with the degree of inflammation at baseline or followup. The frequency of facial asymmetry tended to be lower at follow-up than at initial examination (24% versus 45%, p=0.056).

CONCLUSION

Our results suggest that systemic treatment of TMJ arthritis in children with JIA decreases the degree of inflammation seen on MRI, preserves osseous TMJ morphology and maintains normal mandibular ramus growth.

Abstract

OBJECTIVE

To investigate the course of temporomandibular joint (TMJ) inflammation, osseous deformation and mandibular ramus growth in children with juvenile idiopathic arthritis (JIA) during systemic therapy.

METHODS

Longitudinal study of 38 consecutive JIA patients (29 female, median age 9.0 years, interquartile range 6.2 to 10.7 years) on systemic therapy with TMJ involvement, with two TMJ magnetic resonance imaging (MRI) examinations ≥ 2 years apart and no TMJ corticosteroid injection. Clinical and MRI findings were compared between initial and follow-up examinations and between TMJs with and without active inflammation at baseline.

RESULTS

Over a median period of 3.6 years (range, 2.0-8.7 years), MRI grade of TMJ inflammation improved (p=0.009) and overall osseous deformity tended to become less severe (p=0.114). In TMJs with arthritis at baseline (46 TMJs), both the grades of inflammation (p<0.001) and deformity (p=0.011) improved. In TMJs with no arthritis at baseline (30 TMJs), the frequency and grade of condylar deformation remained stable. Mandibular ramus growth rates were not significantly different between TMJs with and without arthritis at baseline (1.3 mm/year versus 1.5 mm/year, p=0.273), and were not correlated with the degree of inflammation at baseline or followup. The frequency of facial asymmetry tended to be lower at follow-up than at initial examination (24% versus 45%, p=0.056).

CONCLUSION

Our results suggest that systemic treatment of TMJ arthritis in children with JIA decreases the degree of inflammation seen on MRI, preserves osseous TMJ morphology and maintains normal mandibular ramus growth.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Children's Hospital Zurich > Medical Clinic
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:1 June 2020
Deposited On:15 Nov 2019 10:50
Last Modified:15 Sep 2020 00:01
Publisher:Journal of Rheumatology
ISSN:0315-162X
OA Status:Green
Publisher DOI:https://doi.org/10.3899/jrheum.190168
PubMed ID:31523042

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