PT  - JOURNAL ARTICLE
AU  - Andrea Bollhalder
AU  - Raphael Patcas
AU  - Martina Eichenberger
AU  - Lukas Müller
AU  - Silke Schroeder-Kohler
AU  - Rotraud Katharina  Saurenmann
AU  - Christian Johannes  Kellenberger
TI  - Magnetic Resonance Imaging Follow-up of Temporomandibular Joint Inflammation, Deformation and Mandibular Growth in Juvenile Idiopathic Arthritis Patients on Systemic Treatment
AID  - 10.3899/jrheum.190168
DP  - 2019 Sep 15
TA  - The Journal of Rheumatology
PG  - jrheum.190168
4099  - http://www.jrheum.org/content/early/2019/09/11/jrheum.190168.short
4100  - http://www.jrheum.org/content/early/2019/09/11/jrheum.190168.full
AB  - 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.