title: Are temporomandibular joint signs and symptoms associated with magnetic resonance imaging findings in juvenile idiopathic arthritis patients? A longitudinal study.
abstract: The aims of this longitudinal study were to perform a comprehensive clinical evaluation of temporomandibular joint (TMJ) and to investigate the association between the clinical and magnetic resonance imaging (MRI) findings in the TMJs of patients with juvenile idiopathic arthritis (JIA). Seventy-five patients with JIA participated in this study. All patients underwent a rheumatological examination performed by a paediatric rheumatologist, a TMJ examination performed by a single dentist and an MRI with contrast of the TMJs. These examinations were scheduled on the same date. The patients were examined again 1 year later. Twenty-eight (37.3 %) patients reported symptoms at the first evaluation and 11 (14.7 %) patients at the second evaluation. In relation to signs, 35 (46.7 %) of the patients presented at least one sign at the first evaluation and 29 (38.7 %) at the second. Intense contrast enhancement of TMJ was significantly associated with disease activity (p < 0.001) at the first evaluation and a trend to significance was observed at the second (p = 0.056), with poly/systemic subtypes (p = 0.028 and p = 0.049, respectively), with restricted mouth opening capacity (p = 0.013 and p = 0.001, respectively), with the presence of erosions at both evaluations (p = 0.0001 and p < 0.0001, respectively) and with altered condylar shape at the second evaluation (p = 0.0005). TMJ involvement is highly prevalent in JIA patients, with asymptomatic children presenting severe structural alterations of the TMJ. The TMJ should always be evaluated in JIA patients, even in the absence of signs and symptoms.
authors.affiliation: Department of Pediatrics and Department of Radiology, Universidade Federal de São Paulo - UNIFESP, Rua Guilherme Moura, 95, 05449-010, São Paulo, SP, Brazil. lfzwir@gmail.com.
authors.forename: Liete M L Figueiredo
authors.initials: LM
authors.lastname: Zwir
authors.affiliation: Department of Pediatrics and Department of Radiology, Universidade Federal de São Paulo - UNIFESP, Rua Guilherme Moura, 95, 05449-010, São Paulo, SP, Brazil.
authors.forename: Maria Teresa R A
authors.initials: MT
authors.lastname: Terreri
authors.affiliation: Department of Pediatrics and Department of Radiology, Universidade Federal de São Paulo - UNIFESP, Rua Guilherme Moura, 95, 05449-010, São Paulo, SP, Brazil.
authors.forename: Soraia Ale
authors.initials: SA
authors.lastname: Sousa
authors.affiliation: Department of Pediatrics and Department of Radiology, Universidade Federal de São Paulo - UNIFESP, Rua Guilherme Moura, 95, 05449-010, São Paulo, SP, Brazil.
authors.forename: Artur Rocha Corrêa
authors.initials: AR
authors.lastname: Fernandes
authors.affiliation: Department of Pediatrics and Department of Radiology, Universidade Federal de São Paulo - UNIFESP, Rua Guilherme Moura, 95, 05449-010, São Paulo, SP, Brazil.
authors.forename: Antônio Sérgio
authors.initials: AS
authors.lastname: Guimarães
authors.affiliation: Department of Pediatrics and Department of Radiology, Universidade Federal de São Paulo - UNIFESP, Rua Guilherme Moura, 95, 05449-010, São Paulo, SP, Brazil.
authors.forename: Maria Odete E
authors.initials: MO
authors.lastname: Hilário
mesh_terms: D000293:Adolescent; D001171:Arthritis, Juvenile / Q000453:epidemiology / Q000473:pathology* / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D010808:Physical Examination; D015995:Prevalence; D013704:Temporomandibular Joint / Q000473:pathology* / Q000503:physiopathology; D013705:Temporomandibular Joint Disorders / Q000453:epidemiology / Q000473:pathology* / Q000503:physiopathology; D055815:Young Adult
keywords: Disease activity; Juvenile idiopathic arthritis; Magnetic resonance imaging; Temporomandibular joint
references.citation: Oral Surg Oral Med Oral Pathol. 1966 Feb;21(2):169-77
references.pmid: 5215976
references.citation: Rheumatology (Oxford). 2013 Feb;52(2):363-7
references.pmid: 23065318
references.citation: J Rheumatol. 2007 Sep;34(9):1925-33
references.pmid: 17696265
references.citation: Swed Dent J. 1991;15(2):71-83
references.pmid: 2063264
references.citation: J Rheumatol. 2008 Aug;35(8):1668-75
references.pmid: 18634141
references.citation: Swed Dent J. 2000;24(3):83-92
references.pmid: 11061206
references.citation: J Oral Maxillofac Surg. 2011 Sep;69(9):2321-8
references.pmid: 21514711
references.citation: Arthritis Rheum. 2003 Mar;48(3):585-9
references.pmid: 12632407
references.citation: Arthritis Rheum. 1988 May;31(5):602-11
references.pmid: 3377867
references.citation: Acta Radiol. 2009 Dec;50(10):1182-6
references.pmid: 19922317
references.citation: Curr Opin Rheumatol. 2006 Sep;18(5):490-5
references.pmid: 16896288
references.citation: J Rheumatol. 2012 Sep;39(9):1880-7
references.pmid: 22589268
references.citation: Scand J Rheumatol. 1974;3(2):89-96
references.pmid: 4421408
references.citation: J Rheumatol. 2001 Sep;28(9):2109-15
references.pmid: 11550983
references.citation: J Rheumatol. 2005 Jan;32(1):162-9
references.pmid: 15630742
references.citation: J Rheumatol. 1996 Jan;23(1):159-65
references.pmid: 8838526
references.citation: J Rheumatol. 1995 Oct;22(10 ):1956-61
references.pmid: 8991998
references.citation: Scand J Rheumatol. 1982;11(1):5-12
references.pmid: 7063812
references.citation: J Rheumatol. 2004 Nov;31(11):2290-4
references.pmid: 15517647
references.citation: Arthritis Rheum. 2008 Apr;58(4):1189-96
references.pmid: 18383394
references.citation: Am J Orthod Dentofacial Orthop. 1995 Jan;107(1):67-78
references.pmid: 7817963
references.citation: Ann Rheum Dis. 2006 Jun;65(6):823-5
references.pmid: 16699052
references.citation: Scand J Rheumatol. 1989;18(4):197-204
references.pmid: 2799301
references.citation: Pediatr Dent. 1996 Jul-Aug;18(4):312-9
references.pmid: 8857660
references.citation: Radiology. 1992 Oct;185(1):229-34
references.pmid: 1523314
references.citation: Acta Radiol. 2015 Sep;56(9):1145-52
references.pmid: 25217514
references.citation: J Dent Med. 1965 Jan;20:13-5
references.pmid: 14232340
references.citation: J Rheumatol. 2004 Feb;31(2):390-2
references.pmid: 14760812
references.citation: Pediatr Dent. 2000 May-Jun;22(3):200-6
references.pmid: 10846730
references.citation: Rheumatology (Oxford). 2009 Jun;48(6):680-5
references.pmid: 19386819
references.citation: Eur Radiol. 2009 Mar;19(3):693-700
references.pmid: 18958475
references.citation: Scand J Dent Res. 1993 Oct;101(5):332-8
references.pmid: 8248736
references.citation: Biometrics. 1977 Mar;33(1):159-74
references.pmid: 843571
references.citation: J Rheumatol. 2014 Sep;41(9):1871-7
references.pmid: 24986847
references.citation: J Rheumatol. 2004 Jul;31(7):1418-22
references.pmid: 15229966
references.citation: Acta Odontol Scand. 1974;32(3):147-59
references.pmid: 4531163
references.citation: J Oral Maxillofac Surg. 2005 Sep;63(9):1368-71
references.pmid: 16122603
references.citation: J Rheumatol. 2001 Jul;28(7):1689-92
references.pmid: 11469480
references.citation: Radiology. 1990 Aug;176(2):473-7
references.pmid: 2367663
references.citation: Oral Surg Oral Med Oral Pathol. 1992 Jan;73(1):118-22
references.pmid: 1603550
references.citation: Arthritis Care Res (Hoboken). 2014 Jan;66(1):47-54
references.pmid: 24106204
references.citation: J Oral Rehabil. 1995 Aug;22(8):633-41
references.pmid: 7472737
references.citation: Radiology. 2010 Jul;256(1):191-200
references.pmid: 20574096
references.citation: J Rheumatol. 1998 Jul;25(7):1406-12
references.pmid: 9676776
references.citation: Cleft Palate Craniofac J. 2008 Jan;45(1):57-62
references.pmid: 18215103