Sažetak sa skupa

TEMPOROMANDIBULAR JOINT ARTHRITIS AND THE ROLE OF IMAGING

Tomáš Dallos ; Odjel za pedijatrijsku medicinu, Sveučilište Comenius u Bratislavi, Republika Slovačka
Juraj Lyý ; Odjel za pedijatrijsku medicinu, Sveučilište Comenius u Bratislavi, Republika Slovačka

Sažetak

Temporomandibular joints (TMJs) are complex ginglymoarthrodial articulations. TMJs comprise synovium and can be affected by chronic synovitis. TMJ involvement occurs in up to 50% of children with juvenile idiopathic arthritis (JIA) and can occur in rheumatoid arthritis (RA), too. TMJ arthritis and its sequelae have significant
impact on the function of TMJs and affect quality of life profoundly. In children, early onset TMJ arthritis causes growth disturbances of the mandible with severe cosmetic, dental and functional sequelae. Early diagnosis and treatment are thus essential to prevent permanent damage. Subjective complaints (pain, stiffness, crepitation) have low sensitivity (26%) and even may not be reported by patients with TMJ arthritis. Objective findings (tenderness, crepitation, limited mouth opening or deviation of the mandible) have a somewhat higher sensitivity (26–64%), but are not specific for TMJ arthritis. In children, sequential measurement of the inter-incisor distance and its assessment with age-specific reference values can be helpful. Ultrasound, despite its many advantages, has low sensitivity, but may be a useful screening method. X-rays and X-ray based assessments visualize mainly sequelae of arthritis (erosions, growth abnormalities).Among these, cone-beam CT provides the highest accuracy with a low exposure to radiation. Contrast enhanced MRI can visualize active synovitis in TMJs, differentiate active disease from its sequelae and thus determine the need for therapy, as well as its effectiveness. In summary, TMJ arthritis is frequent, has the potential to cause permanent damage and is difficult to diagnose clinically. Imaging techniques improve diagnostic accuracy, among these contrast-enhanced MRI a cone-beam CT are most helpful for identification of active synovitis and its sequelae, respectively.
References:
1. Abramowicz S, Cheon JE, Kim S, et al. Magnetic resonance imaging of temporomandibular joints in children with arthritis. J Oral Maxillofac Surg. 2011 Sep;69(9):2321–8. doi: 10.1016/j.joms.2010.12.058
2. Rehan OM, Saleh HAK, Raff at HA, et al. Osseous changes in the temporomandibular joint in rheumatoid arthritis: A cone-beam
computed tomography study. Imaging Sci Dent. 2018 Mar;48(1):1–9. doi: 10.5624/isd.2018.48.1.1.
3. Hsieh YJ, Darvann TA, Hermann NV, Larsen et al. Facial morphology in children and adolescents with juvenile idiopathic arthritis and moderate to severe temporomandibular joint involvement. Am J Orthod Dentofacial Orthop. 2016 Feb;149(2):182–91. doi: 10.1016/j.ajodo.2015.07.033.
4. Caruso P, Buch K, Rincon S, et al. Optimization of Quantitative Dynamic Postgadolinium MRI Technique Using Normalized Ratios
for the Evaluation of Temporomandibular Joint Synovitis in Patients with Juvenile Idiopathic Arthritis. AJNR Am J Neuroradiol. 2017
Dec;38(12):2344–2350. doi: 10.3174/ajnr.A5424.

Ključne riječi

Hrčak ID:

212203

URI

https://hrcak.srce.hr/212203

Datum izdavanja:

5.12.2018.

Posjeta: 623 *