Temporomandibular joint arthritis in juvenile idiopathic arthritis: the forgotten joint.
OBJECTIVE
This review explores the prevalence, clinical and radiographic signs, and treatment of temporomandibular joint arthritis in children with juvenile idiopathic arthritis.


RESULTS
Temporomandibular joint arthritis seems to be a more frequent manifestation in patients with juvenile idiopathic arthritis than previously believed, in part due to the paucity of clinical symptoms and poor sensitivity of conventional radiographs used for diagnosis. Antinuclear antibody positivity, early onset of disease, and presence of systemic or polyarticular disease are all risk factors for temporomandibular joint arthritis but may underpredict temporomandibular joint involvement in juvenile idiopathic arthritis. Magnetic resonance imaging enhanced with gadolinium is currently the gold standard in detection of temporomandibular joint arthritis, and treatment with intra-articular corticosteroids has been shown to be effective and safe, with minimal side effects.


CONCLUSIONS
Given the paucity of clinical symptoms in temporomandibular joint arthritis, detection of temporomandibular joint inflammation using contrast-enhanced magnetic resonance imaging is essential for instituting appropriate therapy in a timely fashion. The use of intra-articular corticosteroids holds promise for control of temporomandibular joint inflammation and prevention of associated morbidities.
Arabshahi
Bita
B
Division of Rheumatology, Children's Hospital of Philadelphia, 3615 Civic Center Boulevard, Philadelphia, PA 19104, USA.
Cron
Randy Q
RQ
D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D001171:Arthritis, Juvenile / Q000175:diagnosis* / Q000188:drug therapy* / Q000473:pathology; D002648:Child; D002675:Child, Preschool; D006801:Humans; D013704:Temporomandibular Joint / Q000473:pathology; D013705:Temporomandibular Joint Disorders / Q000175:diagnosis* / Q000188:drug therapy* / Q000473:pathology
D000305:Adrenal Cortex Hormones