TY - JOUR T1 - Silent Joint in Dispute. Is Intraarticular Treatment of Temporomandibular Joint Questionable? JF - The Journal of Rheumatology JO - J Rheumatol SP - 1361 LP - 1363 DO - 10.3899/jrheum.150653 VL - 42 IS - 8 AU - TROELS HERLIN AU - THOMAS KLIT PEDERSEN Y1 - 2015/08/01 UR - http://www.jrheum.org/content/42/8/1361.abstract N2 - Involvement of the temporomandibular joint (TMJ) has a high prevalence in children with juvenile idiopathic arthritis (JIA)1,2. Arthritis of the TMJ in the growing, young individual can have significant implications for craniomandibular growth and development3,4,5. This is because the mandibular condylar cartilage serves as the basis of the primary mandibular endochondral growth site since the growth site is placed within the intracapsular joint. Treatment aims have been to reduce TMJ inflammation and to reduce craniofacial disturbances with normalization of growth. TMJ arthritis, due to the unobtrusive character of the inflammation, has been infrequently recognized, and TMJ has been given its moniker “the forgotten joint”6. However, within recent years no other single joint has received as much attention in patients with JIA as the TMJ.Locally administered therapy, typically in the form of intraarticular corticosteroids (IACS) in the TMJ, has been a frequent strategy in the management of children with JIA within the last 10 years7,8,9,10,11,12. In general, studies have reported on symptomatic relief after IACS injection in the TMJ, including reduced pain and changes in the physical examination findings of maximal incisal opening7,8,12. Two of these studies reported magnetic resonance imaging (MRI) changes with improved effusion in 67%8 and reduced inflammation in the TMJ in 39%12 after IACS. The use of IACS in TMJ has been performed in the light of recognizing IACS as … Address correspondence to Prof. Herlin, Department of Pediatrics, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, Aarhus N, Denmark. E-mail: troeherl{at}rm.dk ER -