TY - JOUR T1 - Clinical Diagnosis of Temporomandibular Joint Arthritis: A Difficult Task JF - The Journal of Rheumatology JO - J Rheumatol SP - 1734 LP - 1736 DO - 10.3899/jrheum.140851 VL - 41 IS - 9 AU - ROTRAUD SAURENMANN Y1 - 2014/09/01 UR - http://www.jrheum.org/content/41/9/1734.abstract N2 - Juvenile idiopathic arthritis (JIA) frequently involves the temporomandibular joint (TMJ). TMJ involvement was already mentioned as a typical manifestation in the original publication by Sir Frederic Still1. Depending on the methods used, a rate of up to 93% of JIA patients with early inflammatory signs on TMJ imaging have been reported2,3,4,5. The rates reported for TMJ deformation and important mandibular growth disturbance are only slightly lower with 41–78%6,7,8,9,10. Thus, early diagnosis and timely treatment of TMJ arthritis is important in efforts to prevent such irreversible damage.A number of factors contribute to the difficulties connected to the diagnosis of TMJ arthritis:Severity of consequences. The TMJ is a rather small joint and therefore may be regarded of minor importance. However, it has some unique features: movements in the TMJ are of high complexity, and the mechanical load during chewing and biting is higher than in any other joint of the body. Another peculiarity is that the growth of the mandible during childhood originates from a thin layer of growth cartilage cells located just beneath the joint surface11. Therefore, TMJ arthritis in children can not only lead to deformity and destruction of the mandibular head but can also severely affect the growth and development of the whole mandible. Especially in cases with early onset of TMJ arthritis, the resulting growth failure of the mandible will lead to hypognathism and retrognathism and may have important esthetic and functional consequences, the most severe form being a … Address correspondence to Dr. Saurenmann; E-mail: traudel.saurenmann{at}ksw.ch ER -