title: Orofacial symptoms related to temporomandibular joint arthritis in juvenile idiopathic arthritis: smallest detectable difference in self-reported pain intensity.
abstract: OBJECTIVE
  Temporomandibular joint (TMJ) inflammation in patients with juvenile idiopathic arthritis (JIA) may lead to mandibular growth disturbances and interfere with optimal joint and muscle function. Orofacial symptoms are common clinical findings in relation to TMJ arthritis in adolescence. Knowledge about their clinical manifestation is important for TMJ arthritis diagnosis, treatment choice, and outcome evaluation. The aim of our prospective observational study was to evaluate and describe the frequency, the main complaints, and the localization of TMJ arthritis-related orofacial symptoms. The smallest detectable differences (SDD) for minimal, average, and maximal pain were estimated.
  
  
  METHODS
  Thirty-three patients with JIA and arthritis-related orofacial symptoms in relation to 55 affected TMJ were included in our questionnaire study (mean age 14.11 yrs). Calculation of the SDD was based on a duplicate assessment 45 min after the first questionnaire was completed.
  
  
  RESULTS
  The majority of the patients had common orofacial symptoms during mastication and maximal mouth opening procedures. Persistent orofacial symptoms were rare. The TMJ area in combination with the masseter muscle region was the orofacial region where symptoms were most common. The SDD for minimal, average, and maximal pain were between 10 and 14 mm on a visual analog scale.
  
  
  CONCLUSIONS
  Our study offers new knowledge about TMJ arthritis-related orofacial symptoms that may aid diagnosis and clinical decision-making. We suggest that TMJ arthritis-related orofacial symptoms could be understood as products of the primary TMJ inflammation in combination with secondary myogenic and functional issues.
authors.affiliation: Department of Orthodontics and the Department of Pediatrics, Aarhus University Hospital, Aarhus, Denmark. pstoustrup@odont.au.dk
authors.forename: Peter
authors.initials: P
authors.lastname: Stoustrup
authors.forename: Kasper D
authors.initials: KD
authors.lastname: Kristensen
authors.forename: Carlalberta
authors.initials: C
authors.lastname: Verna
authors.forename: Annelise
authors.initials: A
authors.lastname: Küseler
authors.forename: Troels
authors.initials: T
authors.lastname: Herlin
authors.forename: Thomas K
authors.initials: TK
authors.lastname: Pedersen
mesh_terms: D000293:Adolescent; D001171:Arthritis, Juvenile / Q000150:complications / Q000473:pathology* / Q000503:physiopathology; D002648:Child; D059026:Diagnostic Self Evaluation; D004056:Differential Threshold; D005260:Female; D006801:Humans; D008297:Male; D010146:Pain / Q000209:etiology / Q000473:pathology* / Q000503:physiopathology; D010147:Pain Measurement; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D013704:Temporomandibular Joint / Q000473:pathology* / Q000503:physiopathology; D013705:Temporomandibular Joint Disorders / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D055815:Young Adult