Risk Factors for Temporomandibular Joint Arthritis in Children with Juvenile Idiopathic Arthritis

Objective. To determine the prevalence and features of temporomandibular joint (TMJ) arthritis by magnetic resonance imaging (MRI) among children with juvenile idiopathic arthritis (JIA), and to identify risk factors for TMJ arthritis. Methods. A retrospective chart review was performed on 187 patients with JIA who underwent a TMJ MRI at Children's Hospital of Alabama between September 2007 and June 2010. Demographic and clinical information was abstracted from the charts. Univariate and multivariate analyses were performed to identify risk factors for TMJ arthritis identified by MRI. Results. MRI evidence of TMJ arthritis was detected in 43% of patients, with no significant difference among JIA categories. The number of joints with active arthritis (exclusive of the TMJ) and the use of systemic immunomodulatory therapies were not associated with TMJ arthritis. Multivariable analysis revealed a strong association between mouth-opening deviation and TMJ arthritis (OR 6.21, 95% CI 2.87-13.4). A smaller maximal incisal opening and shorter disease duration were also associated with an increased risk of TMJ arthritis. Conclusion. TMJ arthritis was identified in a substantial proportion of children with HA (43%) and affects all JIA categories. TMJ arthritis was present in some patients despite limited or otherwise quiescent disease and in the presence of concurrent systemic immunomodulatory therapy. Routine evaluation for TMJ arthritis by MRI is warranted for all children with JIA. (First Release May 15 2012; J Rheumatol 2012;39:1880-7; doi:10.3899/jrheum.111441)