Temporomandibular joint involvement occurs in up to 87% of the children with juvenile idiopathic with half of the patients being asymptomatic. In these cases the only option to diagnose arthritis of the temporomandibular joints is the gadolinium enhanced magnetic resonance imaging. Therapeutic approaches include drugs, orthodontic and physiotherapeutic management, although only scant data on the effectiveness of these treatments are available. Several reports in recent years have pointed to imaging guided intraarticular steroids as efficient treatment.