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The temporomandibular joint in juvenile rheumatoid arthritis: I. Computed tomographic findings
1Department of Oral and Maxillofacial Surgery and Pharmacology, Baylor College of Dentistry, Dallas, Texas, USA.
Insights
Juvenile rheumatoid arthritis (JRA) significantly impacts children's temporomandibular joints (TMJ), causing abnormalities and destruction. Early detection through CT scans is crucial for managing this condition.
Area of Science:
- Pediatric Rheumatology
- Medical Imaging
- Orthodontics
Background:
- Juvenile rheumatoid arthritis (JRA) is a chronic inflammatory condition affecting children.
- Temporomandibular joint (TMJ) involvement can lead to significant morbidity in JRA patients.
Purpose of the Study:
- To evaluate TMJ morphology in children with JRA using computed tomography (CT).
- To identify and quantify TMJ abnormalities associated with JRA.
Main Methods:
- Clinical examinations and axial CT scans were performed on 37 JRA patients (ages 6-17).
- Qualitative and quantitative morphological assessments of the TMJ were conducted.
- A control group of 10 healthy children was included for comparison.
- Statistical analysis using ANOVA and nonparametric models was employed.
Main Results:
- CT revealed TMJ abnormalities in 62% of JRA patients.
- JRA subjects exhibited significantly higher TMJ pathosis indices compared to controls (P < 0.03).
- Narrower joint spaces were observed in JRA patients (P < 0.02), indicating joint destruction.
Conclusions:
- Children with JRA have a substantial risk of TMJ involvement.
- CT imaging is effective in detecting TMJ destruction in JRA.
- Early identification of TMJ sequelae is vital for managing JRA patients.
Abstract:
The temporomandibular joints (TMJ) of children afflicted with juvenile rheumatoid arthritis (JRA) were evaluated with clinical examinations and computed tomography (CT). Thirty-seven consecutive patients (6-17 years old) from the Texas Scottish Rite Hospital arthritis clinic were studied to investigate morphological abnormalities in the TMJ by CT. Both qualitative and quantitative measures of TMJ morphology were made from axial CT scans. Ten children without JRA served as a control group. Various ANOVA and nonparametric statistical models were used for analysis. Evidence of TMJ abnormalities from the CTs was found in 62% of these JRA children. The TMJ pathosis indices for left and right joints were significantly higher in the JRA subjects than those in the control children (P < 0.03) and joint spaces were narrower (P < 0.02). These features are indicative of TMJ destruction. Thus, there is considerable risk for TMJ involvement and its debilitating and deforming sequelae in children afflicted with JRA.