Arthritis & Rheumatism, Volume 62,
November 2010 Abstract Supplement

Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Atlanta, Georgia November 6-11, 2010.


Magnetic Resonance Imaging Findings of Temporomandibular Joint in Patients with Active and Inactive Juvenile Idiopathic Arthritis.

Zwir,  Liete, Souza,  Soraia, Terreri,  Maria Teresa, Guimaraes,  Antônio Sérgio, Fernandes,  Artur, Hilario,  Maria Odete

Introduction:

The temporomandibular joint (TMJ), like any other synovial joint, may be involved in Juvenile Idiopathic Arthritis (JIA). According to literature, the frequency of TMJ involvement varies from 17 to 87%, depending on the population under study, on the subtype of the disease and on the method of image used.

TMJ involvement is, generally, associated to early onset of the disease, polyarticular subtype JIA, and long-duration of the disease. Condylar damage may be present early in the disease course and progress, even in absence of clinical symptoms or signs.

Gadolinium-enhanced magnetic resonance imaging (MRI) is a well-established technique considered to be the gold standard to detect TMJ arthritis in JIA even in asymptomatic cases.

Materials and Methods:

Ninety-three consecutive patients (61 girls and 28 boys) who presented to our outpatient pediatric rheumatology clinic and fulfilled the ILAR criteria of JIA were included in this study. The mean age was 12.7 years (range 5 – 20 years) and the median follow-up time at the examination was 6.2 years (0.6 to 18).

The patients were divided into 3 groups: patients with active disease (40 children), patients with inactive disease on medication (20 children) and patients with inactive disease off medication (29 children). For practical reasons the patients were classified in oligoarticular and polyarticular course type.

All patients underwent Gadolinium Enhanced MRI. The findings were blindly evaluated by two observers. Presence of TMJ synovial enhancement was considered to be pathological.

Results:

Forty-eight patients were oligoarticular (16 active, 13 in remission on medication and 19 in remission off medication) and 45 were polyarticular (26 active, 8 in remission on medication and 11 in remission off medication). The tables below show MRI findings according to JIA activity status and subtype of the disease.

Conclusion:

A large number (65%) of patients considered as being in remission off medication presented inflammatory TMJ alterations in RMI. Although synovial enhancement is considered the gold standard in assessing TMJ involvement, we should be cautious in interpreting this finding.

TMJ Synovial EnhancementActive (n = 40)Remission on medication (n = 20)Remission off medication (n = 29)Total
Yes32141965
No861024
Total40202989
TMJ Synovial EnhancementOligoPolyTotal
Yes333265
No121224
Total454489

To cite this abstract, please use the following information:
Zwir, Liete, Souza, Soraia, Terreri, Maria Teresa, Guimaraes, Antônio Sérgio, Fernandes, Artur, Hilario, Maria Odete; Magnetic Resonance Imaging Findings of Temporomandibular Joint in Patients with Active and Inactive Juvenile Idiopathic Arthritis. [abstract]. Arthritis Rheum 2010;62 Suppl 10 :228
DOI: 10.1002/art.27997

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