Magnetic Resonance Imaging Findings following Intraarticular Infliximab Therapy for Refractory Temporomandibular Joint Arthritis among Children with Juvenile Idiopathic Arthritis.
OBJECTIVE
To evaluate the involvement of intraarticular (IA) infliximab (IFX) in the management of temporomandibular joint (TMJ) arthritis associated with juvenile idiopathic arthritis (JIA) that is refractory to systemic treatment and IA corticosteroid therapy.


METHODS
Ours was a retrospective study of children with JIA who received IA IFX into the TMJ. The effectiveness of treatment on the progression of acute and chronic changes was assessed by a quantitative magnetic resonance imaging scoring system.


RESULTS
Median acute and chronic scores worsened by 0.25 and 0.75, respectively. In multivariate analysis, worsening acute scores and passage of time predicted worsening of the chronic scores.


CONCLUSIONS
IA IFX allowed for progression of refractory TMJ arthritis in most but not all children with JIA.
Form the Department of Pediatrics, and Department of Oral and Maxillofacial Surgery, University of Alabama at Birmingham; Department of Radiology, Children's of Alabama, Birmingham, Alabama, USA.M.L. Stoll, MD, PhD, MSCS, Department of Pediatrics, University of Alabama at Birmingham; Y.N. Vaid, MD; S. Guleria, MD, Department of Radiology, Children's of Alabama; T. Beukelman, MD, MSCE, Department of Pediatrics, University of Alabama at Birmingham; P.D. Waite, MPH, DDS, MD, Department of Oral and Maxillofacial Surgery, University of Alabama at Birmingham; R.Q. Cron, MD, PhD, Department of Pediatrics, University of Alabama at Birmingham. mstoll@peds.uab.edu.
Matthew Laurence
ML
Stoll
Form the Department of Pediatrics, and Department of Oral and Maxillofacial Surgery, University of Alabama at Birmingham; Department of Radiology, Children's of Alabama, Birmingham, Alabama, USA.M.L. Stoll, MD, PhD, MSCS, Department of Pediatrics, University of Alabama at Birmingham; Y.N. Vaid, MD; S. Guleria, MD, Department of Radiology, Children's of Alabama; T. Beukelman, MD, MSCE, Department of Pediatrics, University of Alabama at Birmingham; P.D. Waite, MPH, DDS, MD, Department of Oral and Maxillofacial Surgery, University of Alabama at Birmingham; R.Q. Cron, MD, PhD, Department of Pediatrics, University of Alabama at Birmingham.
Yoginder Nath
YN
Vaid
Form the Department of Pediatrics, and Department of Oral and Maxillofacial Surgery, University of Alabama at Birmingham; Department of Radiology, Children's of Alabama, Birmingham, Alabama, USA.M.L. Stoll, MD, PhD, MSCS, Department of Pediatrics, University of Alabama at Birmingham; Y.N. Vaid, MD; S. Guleria, MD, Department of Radiology, Children's of Alabama; T. Beukelman, MD, MSCE, Department of Pediatrics, University of Alabama at Birmingham; P.D. Waite, MPH, DDS, MD, Department of Oral and Maxillofacial Surgery, University of Alabama at Birmingham; R.Q. Cron, MD, PhD, Department of Pediatrics, University of Alabama at Birmingham.
Saurabh
S
Guleria
Form the Department of Pediatrics, and Department of Oral and Maxillofacial Surgery, University of Alabama at Birmingham; Department of Radiology, Children's of Alabama, Birmingham, Alabama, USA.M.L. Stoll, MD, PhD, MSCS, Department of Pediatrics, University of Alabama at Birmingham; Y.N. Vaid, MD; S. Guleria, MD, Department of Radiology, Children's of Alabama; T. Beukelman, MD, MSCE, Department of Pediatrics, University of Alabama at Birmingham; P.D. Waite, MPH, DDS, MD, Department of Oral and Maxillofacial Surgery, University of Alabama at Birmingham; R.Q. Cron, MD, PhD, Department of Pediatrics, University of Alabama at Birmingham.
Timothy
T
Beukelman
Form the Department of Pediatrics, and Department of Oral and Maxillofacial Surgery, University of Alabama at Birmingham; Department of Radiology, Children's of Alabama, Birmingham, Alabama, USA.M.L. Stoll, MD, PhD, MSCS, Department of Pediatrics, University of Alabama at Birmingham; Y.N. Vaid, MD; S. Guleria, MD, Department of Radiology, Children's of Alabama; T. Beukelman, MD, MSCE, Department of Pediatrics, University of Alabama at Birmingham; P.D. Waite, MPH, DDS, MD, Department of Oral and Maxillofacial Surgery, University of Alabama at Birmingham; R.Q. Cron, MD, PhD, Department of Pediatrics, University of Alabama at Birmingham.
Peter Daniel
PD
Waite
Form the Department of Pediatrics, and Department of Oral and Maxillofacial Surgery, University of Alabama at Birmingham; Department of Radiology, Children's of Alabama, Birmingham, Alabama, USA.M.L. Stoll, MD, PhD, MSCS, Department of Pediatrics, University of Alabama at Birmingham; Y.N. Vaid, MD; S. Guleria, MD, Department of Radiology, Children's of Alabama; T. Beukelman, MD, MSCE, Department of Pediatrics, University of Alabama at Birmingham; P.D. Waite, MPH, DDS, MD, Department of Oral and Maxillofacial Surgery, University of Alabama at Birmingham; R.Q. Cron, MD, PhD, Department of Pediatrics, University of Alabama at Birmingham.
Randy Quentin
RQ
Cron
D000293:Adolescent; D000704:Analysis of Variance; D001171:Arthritis, Juvenile / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D000069285:Infliximab / Q000008:administration & dosage*; D007270:Injections, Intra-Articular; D016014:Linear Models; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D015999:Multivariate Analysis; D010147:Pain Measurement; D012008:Recurrence; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D013705:Temporomandibular Joint Disorders / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology*; D016896:Treatment Outcome; D014481:United States
D000069285:Infliximab
INFLIXIMAB; INTRAARTICULAR INJECTIONS; JUVENILE IDIOPATHIC ARTHRITIS; MAGNETIC RESONANCE IMAGING; TEMPOROMANDIBULAR JOINT