Juvenile idiopathic arthritis with involvement of the temporomandibular joint: the role of image examinations

Authors

  • Karina Ivette Sánchez Effio
  • Luciana Maria Paes da Silva Ramos Fernandes
  • Marcelo Eduardo Pereira Dutra
  • Marcelo Marcucci
  • Jefferson Xavier de Oliveira

Keywords:

Juvenile idiopathic arthritis, temporomandibular joint, computed tomography, magnetic resonance imaging

Abstract

Purpose: Juvenile idiopathic arthritis (JIA) has unknown etiology, and the involvement of the temporomandibular joint (TMJ) is rare in the early phase of the disease. The present article describes the use of computed tomography (CT) and magnetic resonance (MRI) images for the diagnosis of affected TMJ in JIA. Case description: A 12-year-old, female, Caucasian patient, with systemic rheumathoid arthritis and involvement of multiple joints was referred to the Imaging Center for TMJ assessment. The patient reported TMJ pain and limited opening of the mouth. The helical CT examination of the TMJ region showed asymmetric mandibular condyles, erosion of the right condyle and osteophyte-like formation. The MRI examination showed erosion of the right mandibular condyle, osteophytes, displacement without reduction and disruption of the articular disc. Conclusion: The disorders of the TMJ as a consequence of JIA must be carefully assessed by modern imaging methods such as CT and MRI. CT is very useful for the evaluation of discrete bone changes, which are not identified by conventional radiographs in the early phase of JIA. MRI allows the evaluation of soft tissues, the identification of acute articular inflammation and the differentiation between pannus and synovial hypertrophy.

Author Biographies

Karina Ivette Sánchez Effio

Especialista em Radiologia e Imaginologia Odontológica pela FUNDECTO-FOUSP

Luciana Maria Paes da Silva Ramos Fernandes

Especialista em Radiologia e Imaginologia Odontológica pela FUNDECTO-FOUSP

Marcelo Eduardo Pereira Dutra

Mestre e Doutor em Diagnóstico Bucal pela FO-USP.

Marcelo Marcucci

Diretor Técnico do Serviço de Estomatologia e Cirurgia Bucomaxilofacial do Hospital Heliópolis-SP.

Jefferson Xavier de Oliveira

Professor Associado da Disciplina de Radiologia da Faculdade de Odontologia da Universidade de São Paulo-FO-USP.

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Published

2009-11-17

Issue

Section

Case Report