Evaluation of temporomandibular joint involvement in juvenile idiopathic arthritis patients
Abstract Objective Juvenile idiopathic arthritis (JIA) is a common, chronic and inflammatory rheumatological disease of childhood. The disease can affect all synovial joints in the body. Temporomandibular joints (TMJs) are important areas of involvement in JIA, which are frequently involved but ofte...
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BMC
2024-11-01
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| Series: | Pediatric Rheumatology Online Journal |
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| Online Access: | https://doi.org/10.1186/s12969-024-01031-w |
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| author | Asena Pinar Sefer Muferet Erguven |
| author_facet | Asena Pinar Sefer Muferet Erguven |
| author_sort | Asena Pinar Sefer |
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| description | Abstract Objective Juvenile idiopathic arthritis (JIA) is a common, chronic and inflammatory rheumatological disease of childhood. The disease can affect all synovial joints in the body. Temporomandibular joints (TMJs) are important areas of involvement in JIA, which are frequently involved but often not noticed because the involvement is usually asymptomatic. The aim of this study is to determine the frequency and risk factors of TMJ joint involvement in juvenile idiopathic arthritis patients admitted to our clinic, and to guide for early diagnosis and treatment. Methods Patients who applied to this study with the diagnosis of JIA between January 2014 and May 2017 at Pediatric Rheumatology Clinic, were followed up regularly in our clinic, had a accessible medical history, and a rheumatology polyclinic record. Patients with contrast-enhanced TMJ Magnetic Resonance Imaging (MRI) taken and reported by the radiologist were included. Results TMJ involvement was detected in 51.2% of the 41 patients included in the study. It was found that 71.5% of the patients with TMJ involvement were asymptomatic and 71.5% of the patients had chronic involvement. When the patients with and without TMJ involvement were compared according to the contrast-enhanced TMJ MRI results; In the patient group with involvement, the polyarticular onset subtype was seen at a higher rate (p = 0.005), the age of onset was earlier (p = 0.003), the disease duration was longer (p = 0.037), more joints were involved (p = 0.005), the ESR values were higher (p = 0.0001), and the treatment compliance and treatment responses of the patients in this group were worse (p = 0.001, p = 0.0001). Conclusion TMJ involvement is common in JIA patients and can occur at any stage of the disease. It is often asymptomatic and progresses insidiously, leading to chronic and degenerative changes in the mandible at an early stage. Due to its asymptomatic nature, the insidious progression, and the risk of causing chronic, irreversible sequelae, it is crucial to screen high-risk JIA patients regularly with contrast-enhanced TMJ MRI, which remains the gold standard method. While specific risk factors are difficult to pinpoint, some factors may increase the likelihood of TMJ involvement. To better identify these high-risk patients and determine which individuals require regular screening, larger-scale and multicenter studies are essential. |
| format | Article |
| id | doaj-art-8be1ff20e5cf4a809784734da7e3f8e4 |
| institution | Kabale University |
| issn | 1546-0096 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | BMC |
| record_format | Article |
| series | Pediatric Rheumatology Online Journal |
| spelling | doaj-art-8be1ff20e5cf4a809784734da7e3f8e42024-12-01T12:14:04ZengBMCPediatric Rheumatology Online Journal1546-00962024-11-012211810.1186/s12969-024-01031-wEvaluation of temporomandibular joint involvement in juvenile idiopathic arthritis patientsAsena Pinar Sefer0Muferet Erguven1School of Medicine, Division of Pediatric Allergy and Immunology, Recep Tayyip Erdogan UniversitySchool of Medicine, Division of Pediatric Allergy and Immunology, Recep Tayyip Erdogan UniversityAbstract Objective Juvenile idiopathic arthritis (JIA) is a common, chronic and inflammatory rheumatological disease of childhood. The disease can affect all synovial joints in the body. Temporomandibular joints (TMJs) are important areas of involvement in JIA, which are frequently involved but often not noticed because the involvement is usually asymptomatic. The aim of this study is to determine the frequency and risk factors of TMJ joint involvement in juvenile idiopathic arthritis patients admitted to our clinic, and to guide for early diagnosis and treatment. Methods Patients who applied to this study with the diagnosis of JIA between January 2014 and May 2017 at Pediatric Rheumatology Clinic, were followed up regularly in our clinic, had a accessible medical history, and a rheumatology polyclinic record. Patients with contrast-enhanced TMJ Magnetic Resonance Imaging (MRI) taken and reported by the radiologist were included. Results TMJ involvement was detected in 51.2% of the 41 patients included in the study. It was found that 71.5% of the patients with TMJ involvement were asymptomatic and 71.5% of the patients had chronic involvement. When the patients with and without TMJ involvement were compared according to the contrast-enhanced TMJ MRI results; In the patient group with involvement, the polyarticular onset subtype was seen at a higher rate (p = 0.005), the age of onset was earlier (p = 0.003), the disease duration was longer (p = 0.037), more joints were involved (p = 0.005), the ESR values were higher (p = 0.0001), and the treatment compliance and treatment responses of the patients in this group were worse (p = 0.001, p = 0.0001). Conclusion TMJ involvement is common in JIA patients and can occur at any stage of the disease. It is often asymptomatic and progresses insidiously, leading to chronic and degenerative changes in the mandible at an early stage. Due to its asymptomatic nature, the insidious progression, and the risk of causing chronic, irreversible sequelae, it is crucial to screen high-risk JIA patients regularly with contrast-enhanced TMJ MRI, which remains the gold standard method. While specific risk factors are difficult to pinpoint, some factors may increase the likelihood of TMJ involvement. To better identify these high-risk patients and determine which individuals require regular screening, larger-scale and multicenter studies are essential.https://doi.org/10.1186/s12969-024-01031-wJuvenil idiopathic arthritisMagnetic resonance imagingTemporomandibular joint |
| spellingShingle | Asena Pinar Sefer Muferet Erguven Evaluation of temporomandibular joint involvement in juvenile idiopathic arthritis patients Pediatric Rheumatology Online Journal Juvenil idiopathic arthritis Magnetic resonance imaging Temporomandibular joint |
| title | Evaluation of temporomandibular joint involvement in juvenile idiopathic arthritis patients |
| title_full | Evaluation of temporomandibular joint involvement in juvenile idiopathic arthritis patients |
| title_fullStr | Evaluation of temporomandibular joint involvement in juvenile idiopathic arthritis patients |
| title_full_unstemmed | Evaluation of temporomandibular joint involvement in juvenile idiopathic arthritis patients |
| title_short | Evaluation of temporomandibular joint involvement in juvenile idiopathic arthritis patients |
| title_sort | evaluation of temporomandibular joint involvement in juvenile idiopathic arthritis patients |
| topic | Juvenil idiopathic arthritis Magnetic resonance imaging Temporomandibular joint |
| url | https://doi.org/10.1186/s12969-024-01031-w |
| work_keys_str_mv | AT asenapinarsefer evaluationoftemporomandibularjointinvolvementinjuvenileidiopathicarthritispatients AT mufereterguven evaluationoftemporomandibularjointinvolvementinjuvenileidiopathicarthritispatients |