title: Arthroscopy of the Temporomandibular Joint in Patients With Juvenile Idiopathic Arthritis.
abstract: OBJECTIVE
  The early diagnosis of temporomandibular joint (TMJ) involvement in patients with juvenile idiopathic arthritis (JIA) before joint destruction and growth disturbances could allow for interceptive treatment. The purpose of this article is to report early TMJ arthroscopic findings in patients with JIA.
  
  
  METHODS
  This was a case series of 3 patients with JIA treated at the Emory University Division of Oral and Maxillofacial Surgery from July 2011 through December 2012. Patients were included if they had a confirmed diagnosis of JIA, did not respond to anti-rheumatologic medication, and had TMJ pain or limited mouth opening. All patients underwent TMJ arthroscopy with an injection of triamcinolone hexacetonide. Demographics, medical history, magnetic resonance imaging findings, arthroscopic findings, and postoperative course were reported.
  
  
  RESULTS
  Three female patients (mean age, 12.5 yr; 5 joints) underwent arthroscopy. Arthroscopic findings consisted of mild to moderate synovitis and grade 2 to 4 chondromalacia with or without fibrosis. Postoperatively, all patients had improvement in pain and mouth opening.
  
  
  CONCLUSIONS
  There was a positive correlation between duration of JIA activity in the TMJ and severity of arthroscopic findings. Arthroscopic lysis and lavage combined with triamcinolone hexacetonide injection resulted in improvement in pain and range of motion.
authors.affiliation: Resident, Department of Surgery, Division of Oral and Maxillofacial Surgery, Emory University School of Medicine, Atlanta, GA.
authors.forename: Brian E
authors.initials: BE
authors.lastname: Kinard
authors.affiliation: Associate Professor, Department of Surgery, Division of Oral and Maxillofacial Surgery, Emory University School of Medicine, Atlanta, GA.
authors.forename: Gary F
authors.initials: GF
authors.lastname: Bouloux
authors.affiliation: Marcus Professor and Chief, Division of Pediatric Rheumatology; Professor, Pediatrics and Human Genetics, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, GA.
authors.forename: Sampath
authors.initials: S
authors.lastname: Prahalad
authors.affiliation: Associate Professor, Division of Pediatric Rheumatology; Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, GA.
authors.forename: Larry
authors.initials: L
authors.lastname: Vogler
authors.affiliation: Assistant Professor, Department of Surgery and Pediatrics, Division of Oral and Maxillofacial Surgery, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, GA. Electronic address: sabram5@emory.edu.
authors.forename: Shelly
authors.initials: S
authors.lastname: Abramowicz
mesh_terms: D000293:Adolescent; D001171:Arthritis, Juvenile / Q000150:complications*; D001182:Arthroscopy; D002648:Child; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D011862:Radiography, Panoramic; D013705:Temporomandibular Joint Disorders / Q000175:diagnosis* / Q000209:etiology* / Q000601:surgery*; D055815:Young Adult