title: Is high-resolution ultrasonography suitable for the detection of temporomandibular joint involvement in children with juvenile idiopathic arthritis?
abstract: OBJECTIVE
  The purpose of this study was to determine the potential of high-resolution ultrasonography for the detection of temporomandibular joint (TMJ) changes in children with juvenile idiopathic arthritis (JIA).
  
  
  METHODS
  We investigated prospectively 20 children (17 female and 3 male; mean age 11.06 years, standard deviation 3.43 years) with TMJ disorders caused by JIA, over a period of 16 months. Using a 12 MHz array transducer, four images in each TMJ (160 images) were acquired. Each image was analysed with regard to five different aspects (condylar erosion, thickness of the condylar disc, synovial thickness, joint effusion and enlargement of the intra-articular space).
  
  
  RESULTS
  Diagnosis of JIA was ensured for every child and involvement of the TMJ was proven by MRI. Overall 287 changes (35.9%) were detected by using high-resolution ultrasonography. On 124 images (77.5%) condylar erosions were diagnosed; on 55 images (34.4%) synovial thickness was abnormal; on 48 images (30%) we could see higher thickness of the condylar disc; on 40 images (25%) irregularities of the bony surface were detected; and on 20 images (12.5%) we found joint effusion.
  
  
  CONCLUSIONS
  High-resolution ultrasonography could be a sufficient diagnostic method, especially for the detection of condylar involvement in children with JIA, even if not all parts of the TMJ are visible for ultrasonography. High-resolution ultrasonography is a valuable tool in particular situations: (i) when MRI examination is not available; (ii) when children fear MRI examination; (iii) in more advanced stages of JIA; and (iv) for monitoring the progression of TMJ involvement and response of therapy.
authors: Department of Oral and Cranio- Maxillofacial Surgery, University Medical Center Hamburg Eppendorf, University of Hamburg, Hamburg, Germany. a.assaf@uke.uni-hamburg.de
authors: A T
authors: AT
authors: Assaf
authors: B
authors: B
authors: Kahl-Nieke
authors: J
authors: J
authors: Feddersen
authors: C R
authors: CR
authors: Habermann
mesh_terms: D000293:Adolescent; D001171:Arthritis, Juvenile / Q000097:blood / Q000000981:diagnostic imaging*; D015535:Arthritis, Psoriatic / Q000097:blood / Q000000981:diagnostic imaging*; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008335:Mandibular Condyle / Q000000981:diagnostic imaging / Q000473:pathology; D011446:Prospective Studies; D013583:Synovial Membrane / Q000000981:diagnostic imaging; D013704:Temporomandibular Joint / Q000000981:diagnostic imaging*; D019224:Temporomandibular Joint Disc / Q000000981:diagnostic imaging; D013705:Temporomandibular Joint Disorders / Q000097:blood / Q000000981:diagnostic imaging*; D014463:Ultrasonography / Q000379:methods