Temporomandibular joint findings in adults with long-standing juvenile idiopathic arthritis: CT and MR imaging assessment.
OBJECTIVE
To assess the long-term temporomandibular joint (TMJ) manifestations of juvenile idiopathic arthritis (JIA), as depicted at computed tomography (CT) and magnetic resonance (MR) imaging, in 47 adult patients.


METHODS
The study was approved by a regional committee for medical research ethics, and informed consent was obtained from all patients. Forty-seven patients with JIA (32 women, 15 men; mean age, 35 years) were examined, on average, 30 years after the initial diagnosis. The findings of TMJ imaging, including CT and MR imaging, were evaluated by three observers. Bone and disk abnormalities, joint effusion, bone marrow abnormalities, and contrast enhancement were analyzed.


RESULTS
The TMJs were involved in 33 (70%) of the 47 patients with JIA, with bilateral involvement in 29 patients. Slight to moderate contrast enhancement was observed on the images obtained in 14 (42%) of the 33 patients with TMJ JIA abnormalities. All main joint components were abnormal in 28 of the 33 patients, mainly showing flat deformed condyles, wide flat fossae, and thin or perforated disks in the normal position, or absent disks. Condylar concavity or bifidity, and secondary osteoarthritis were found in approximately half of the abnormal joints.


CONCLUSIONS
Long-term JIA manifestations in the TMJs, as demonstrated at CT and MR imaging, were frequent, usually bilateral, and characterized by mandibular condyle and temporal bone deformities, abnormal disk morphology, and, rather frequently, osteoarthritis and mild synovitis.
Arvidsson
Linda Z
LZ
Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo, Blindern, Oslo, Norway. l.z.arvidsson@odont.uio.no
Smith
Hans-Jørgen
HJ
Flatø
Berit
B
Larheim
Tore A
TA
D000328:Adult; D001171:Arthritis, Juvenile / Q000000981:diagnostic imaging / Q000473:pathology*; D016009:Chi-Square Distribution; D003287:Contrast Media; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009664:Norway; D010003:Osteoarthritis / Q000000981:diagnostic imaging / Q000473:pathology; D013585:Synovitis / Q000000981:diagnostic imaging / Q000473:pathology; D013704:Temporomandibular Joint / Q000000981:diagnostic imaging / Q000473:pathology*; D014057:Tomography, X-Ray Computed
D003287:Contrast Media; D019786:Gadolinium DTPA