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Pediatr Radiol. 2018 Jun;48(6):792-800. doi: 10.1007/s00247-017-4005-8. Epub 2018 May 8.

Imaging of temporomandibular joint abnormalities in juvenile idiopathic arthritis with a focus on developing a magnetic resonance imaging protocol.

Author information

1
Department of Medical Imaging, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada.
2
Department of Diagnostic Imaging, Hospital Sant Joan de Deu, Barcelona, Spain.
3
Pediatric Rheumatology Research Institute, Bad Bramstedt, Germany.
4
Austin Radiological Association, Austin, TX, USA.
5
Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, ON, Canada. m.tolend@mail.utoronto.ca.
6
Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children, 686 Bay Street, 08.9840-L4, Toronto, ON, M5G 1A4, Canada. m.tolend@mail.utoronto.ca.
7
Department of Radiology, Nemours Children's Health System, Orlando, FL, USA.
8
Department of Pediatric Radiology, Radiologisches Institut, Olgahospital Klinikum Stuttgart, Stuttgart, Germany.
9
Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, ON, Canada.
10
Department of Orthodontics, University Hospital Tübingen, Tübingen, Germany.
11
School of Medical Science, University of Campinas, Campinas, Brazil.
12
Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo, Oslo, Norway.
13
Department of Radiology and Nuclear Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway.
14
Department of Diagnostic Imaging, University Children's Hospital, Zürich, Switzerland.

Abstract

Inflammation and damage in the temporomandibular joint (TMJ) often develop without clinical symptoms but can lead to severe facial growth abnormalities and impaired health-related quality of life, making early diagnosis of TMJ changes crucial to identify. Inflammatory and osteochondral changes detectable through magnetic resonance imaging (MRI) occur in TMJs of approximately 40% of children with juvenile idiopathic arthritis (JIA), and no other imaging modality or physical method of examination can reliably detect these changes. Therefore contrast-enhanced MRI is the diagnostic standard for diagnosis and interval monitoring of JIA. However the specific usage of MRI for TMJ arthritis is not standardized at present. There is a recognized need for a consensus effort toward standardization of an imaging protocol with required and optional sequences to improve detection of pathological changes and shorten study time. Such a consensus imaging protocol is important for providing maximum information with minimally necessary sequences in a way that allows inter-site comparison of results of clinical trials and improved clinical management. In this paper we describe the challenges of TMJ imaging and present expert-panel consensus suggestions for a standardized TMJ MRI protocol.

KEYWORDS:

Children; Imaging protocol; Juvenile idiopathic arthritis; Magnetic resonance imaging; Synovitis; Temporomandibular joint

PMID:
29766249
DOI:
10.1007/s00247-017-4005-8
[Indexed for MEDLINE]

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