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Pediatr Radiol. 2016 Mar;46(3):331-41. doi: 10.1007/s00247-015-3493-7. Epub 2015 Dec 5.

Disk abnormality coexists with any degree of synovial and osseous abnormality in the temporomandibular joints of children with juvenile idiopathic arthritis.

Author information

1
Department of Radiology and Nuclear Medicine, Oslo University Hospital, Rikshospitalet, Postbox 4950, Nydalen, N-0424, Oslo, Norway. eva.kirkhus@medisin.uio.no.
2
Institute of Clinical Medicine, University of Oslo, Oslo, Norway. eva.kirkhus@medisin.uio.no.
3
Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo, Oslo, Norway.
4
Department of Radiology and Nuclear Medicine, Oslo University Hospital, Rikshospitalet, Postbox 4950, Nydalen, N-0424, Oslo, Norway.
5
Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
6
Department of Rheumatology, Oslo University Hospital, Rikshospitalet, Oslo, Norway.

Abstract

BACKGROUND:

MRI manifestation of temporomandibular joint arthritis is frequently reported in children with juvenile idiopathic arthritis. However, little attention has been paid to temporomandibular joint disk abnormalities.

OBJECTIVE:

To assess combinations of MRI findings in the symptomatic temporomandibular joint in children with juvenile idiopathic arthritis with focus on disk abnormalities.

MATERIALS AND METHODS:

This was a retrospective study of 46 patients with juvenile idiopathic arthritis, mean age 12 years (range: 5-17 years). Mean disease duration was 70 months (standard deviation: 61 months). MR images of 92 temporomandibular joints were scored for thickness of abnormally enhancing synovium (synovitis), joint effusion, bone marrow oedema, abnormal bone shape, bone erosion and disk abnormalities.

RESULTS:

The 92 temporomandibular joints were categorized as A: No synovitis and normal bone shape (30/92; 33%), B: Synovitis and normal bone shape (14/92: 15%), C: Synovitis and abnormal bone shape (38/92; 41%) and D: No synovitis but abnormal bone shape (10/92; 11%). Thirty-six of the 46 patients (78%) had synovitis and 33/46 (72%) had abnormal bone shape, most frequently in combination (30/46; 65%). Disk abnormalities (flat disk, fragmented disk, adherent disk and displaced disk) were found in 29/46 patients (63%). Disk abnormalities were found in all categories of juvenile idiopathic arthritis involved temporomandibular joints (B: 8/14 [57%]; C: 25/38 [66%] and D: 7/10 [70%]). Disk displacement was found in half of the joints (7/14) in category B. Synovitis was most pronounced in this category.

CONCLUSION:

Disk abnormalities were frequent. Disk displacement also occurred in joints with early temporomandibular joint arthritis, i.e., with normal bone shape. Other disk abnormalities were found in joints with bone abnormalities. Attention should be paid to disk abnormalities both in early and long-standing temporomandibular joint arthritis in children with juvenile idiopathic arthritis.

KEYWORDS:

Child; Juvenile idiopathic arthritis; Magnetic resonance imaging; Synovitis; Temporomandibular joint

PMID:
26637998
DOI:
10.1007/s00247-015-3493-7
[Indexed for MEDLINE]

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