Sonographic investigation of the temporomandibular joint in patients with juvenile idiopathic arthritis:: A pilot study

Objective. To evaluate whether there are any correlations between the clinical parameters of temporomandibular joint (TMJ) arthritis and pathologic ultrasound (US) findings of the TMJ in patients with juvenile idiopathic arthritis (JIA). Methods. We conducted prospective clinical and US investigations of the TMJs of 48 patients with JIA. The US investigation was performed by a 12-MHz high-resolution transducer, which was positioned parallel to the ramus of the mandible overlying the zygomatic arch in a closed-mouth position and maximum open-mouth position. Results. Patients with >= 5 peripheral affected joints showed significantly more sonographically diagnosed destructive changes in the TMJ than did patients with < 5 affected joints. There was no significance between the number of affected peripheral joints and disc dislocation in the closed-mouth position. In the maximum open-mouth position, there was a significant correlation between the number of affected peripheral joints and disc dislocation. Patients with a JIA duration > 23 months had a significantly higher rate of disc dislocation and destructive changes. Patients with a JIA duration > 60 months had a significantly higher rate of destructive changes of the TMJ than patients with a disease duration < 60 months, but no statistical significance was found concerning disc dislocation. Conclusion. The significant correlation between pathologic sonographic findings, duration of JIA, and the number of affected peripheral joints make the technique interesting for use as a diagnostic screening method.