Early diagnosis of temporomandibular joint involvement in juvenile idiopathic arthritis: a pilot study comparing clinical examination and ultrasound to magnetic resonance imaging

Müller, Lukas; Kellenberger, Christian J; Cannizzaro, Elvira; Ettlin, Dominik; Schraner, Thomas; Bolt, Isabel B; Peltomäki, Timo; Saurenmann, Rotraud K (2009). Early diagnosis of temporomandibular joint involvement in juvenile idiopathic arthritis: a pilot study comparing clinical examination and ultrasound to magnetic resonance imaging. Rheumatology, 48(6), pp. 680-5. Oxford: Oxford University Press 10.1093/rheumatology/kep068

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OBJECTIVES: To study the validity of both rheumatological and orthodontic examinations and ultrasound (US) as screening methods for early diagnosis of TMJ arthritis against the gold standard MRI. METHODS: Thirty consecutive juvenile idiopathic arthritis (JIA) patients were included in this pilot study. Rheumatological and orthodontic examinations as well as US were performed within 1 month of the MRI in a blinded fashion. Joint effusion and/or increased contrast enhancement of synovium or bone were considered signs of active arthritis on MRI. RESULTS: A total of 19/30 (63%) patients and 33/60 (55%) joints had signs of TMJ involvement on MRI. This was associated with condylar deformity in 9/19 (47%) patients and 15/33 (45%) joints. Rheumatological, orthodontic and US examinations correctly diagnosed 11 (58%), 9 (47%) and 6 (33%) patients, respectively, with active TMJ arthritis, but misdiagnosed 8 (42%), 10 (53%) and 12 (67%) patients, respectively, as having no signs of inflammation. The best predictor for active arthritis on MRI was a reduced maximum mouth opening. CONCLUSION: None of the methods tested was able to reliably predict the presence or absence of MRI-proven inflammation in the TMJ in our cohort of JIA patients. US was the least useful of all methods tested to exclude active TMJ arthritis.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Paediatric Medicine

UniBE Contributor:

Bolt, Isabel Bettina

ISSN:

1462-0324

Publisher:

Oxford University Press

Language:

English

Submitter:

Anette van Dorland

Date Deposited:

04 Oct 2013 15:12

Last Modified:

05 Dec 2022 14:22

Publisher DOI:

10.1093/rheumatology/kep068

PubMed ID:

19386819

Web of Science ID:

000266109600018

URI:

https://boris.unibe.ch/id/eprint/31836 (FactScience: 196574)

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