Defining the normal appearance of the temporomandibular joints by magnetic resonance imaging with contrast: a comparative study of children with and without juvenile idiopathic arthritis.

Autor: Stoll ML; Department of Pediatrics, University of Alabama at Birmingham, CPP N G10 / 1600 7th Avenue South, Birmingham, AL, 35233, USA. mstoll@peds.uab.edu., Guleria S; Department of Radiology at Children's of Alabama, CH 2 FL / 1600 7th Avenue South, Birmingham, AL, 35233, USA.; Present affiliation: Austin Radiological Associates, Austin, TX, USA., Mannion ML; Department of Pediatrics, University of Alabama at Birmingham, CPP N G10 / 1600 7th Avenue South, Birmingham, AL, 35233, USA., Young DW; Department of Radiology at Children's of Alabama, CH 2 FL / 1600 7th Avenue South, Birmingham, AL, 35233, USA., Royal SA; Department of Radiology at Children's of Alabama, CH 2 FL / 1600 7th Avenue South, Birmingham, AL, 35233, USA., Cron RQ; Department of Pediatrics, University of Alabama at Birmingham, CPP N G10 / 1600 7th Avenue South, Birmingham, AL, 35233, USA., Vaid YN; Department of Radiology at Children's of Alabama, CH 2 FL / 1600 7th Avenue South, Birmingham, AL, 35233, USA.
Jazyk: angličtina
Zdroj: Pediatric rheumatology online journal [Pediatr Rheumatol Online J] 2018 Jan 24; Vol. 16 (1), pp. 8. Date of Electronic Publication: 2018 Jan 24.
DOI: 10.1186/s12969-018-0223-3
Abstrakt: Background: Up to 80% of children with juvenile idiopathic arthritis (JIA) develop arthritis involving their temporomandibular joint (TMJ). Recent studies have questioned the sensitivity of an abnormal MRI in the diagnosis of active arthritis.
Methods: 122 children without arthritis undergoing contrast MRI of the head were prospectively consented to undergo a simultaneous contrast MRI of their TMJs. As a comparison point, the initial MRI of the TMJ of 35 newly diagnosed children with JIA were retrospectively scored. The presence and size of effusion and contrast enhancement were measured in the left TMJ in all subjects.
Results: 62/122 (51%) controls compared to only 10/35 JIA (29%) patients had an effusion (p = 0.022). Contrast enhancement was present in ≥97% of both groups, although the size of the enhancement was, on average, 0.2 mm larger in controls (1.1 ± 0.24 vs 0.88 ± 0.27 mm, p <  0.001). Among JIA patients, the size of the enhancement correlated inversely with disease duration (r = - 0.475, p = 0.005). Chronic changes were present in none of the controls versus 2/35 (5.5%) of the JIA patients (p = 0.049).
Conclusion: Findings consistent with minimally active TMJ arthritis appear to be equally likely in children with JIA as compared to non-inflamed controls, while this and other studies confirm that chronic changes are specific to JIA. Thus, small amounts of effusion or contrast enhancement, in the absence of chronic changes, should be interpreted with caution.
Databáze: MEDLINE
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