Skip to main content
Top
Published in: Oral Radiology 4/2023

Open Access 03-07-2023 | Juvenile Rheumatoid Arthritis | Original Article

Temporomandibular joint involvement in patients with Juvenile Idiopathic Arthritis: comparison of ultrasonography and magnetic resonance imaging in assessing the periarticular space width

Authors: Ingrid Tonni, Giulia Fossati, Maria Luisa Garo, Maria Grazia Piancino, Marco Cattalini, Luca Visconti, Andrea Borghesi

Published in: Oral Radiology | Issue 4/2023

Login to get access

Abstract

Objectives

This study aimed to compare the performance of Ultrasonography (US) and Magnetic Resonance Imaging (MRI) in assessing the Lateral Periarticular Space (LPAS) of Temporomandibular Joints (TMJs) in patients with Juvenile Idiopathic Arthritis (JIA).

Methods

The LPAS width was evaluated in two different patient groups. In the JIA group, including 29 children (13 ± 2.8 years) with JIA, the LPAS width was measured with both MRI and US. In the healthy group, including 28 healthy children (12.6 ± 2.5 years), the LPAS width was measured only with US. Comparisons of LPAS width based on patient groups and TMJ contrast enhancement in MRI were evaluated by applying the Mann–Whitney U test. Correlation and agreement between MRI and US measurements in JIA group were tested using Spearman rank correlation and Bland–Altman method.

Results

The LPAS width was significantly greater in the JIA group than in the healthy group. In the JIA group, the LPAS width was significantly greater in TMJs with moderate/severe enhancement than those with mild enhancement. A positive significant correlation between MRI and US measurements of LPAS width was found in the JIA group. In the same group, Bland–Altman method showed a good level of agreement between MRI and US measurements.

Conclusion

Although, US cannot replace MRI in the evaluation of TMJ in patients with JIA, US could be used as a supplementary imaging method to MRI in assessing the TMJ disease.
Literature
1.
go back to reference Arabshahi B, Cron RQ. Temporomandibular joint arthritis in juvenile idiopathic arthritis: the forgotten joint. Curr Opin Rheumatol. 2006;18(5):490–5.CrossRefPubMed Arabshahi B, Cron RQ. Temporomandibular joint arthritis in juvenile idiopathic arthritis: the forgotten joint. Curr Opin Rheumatol. 2006;18(5):490–5.CrossRefPubMed
2.
go back to reference Cannizzaro E, et al. Temporomandibular joint involvement in children with juvenile idiopathic arthritis. J Rheumatol. 2011;38(3):510–5.CrossRefPubMed Cannizzaro E, et al. Temporomandibular joint involvement in children with juvenile idiopathic arthritis. J Rheumatol. 2011;38(3):510–5.CrossRefPubMed
3.
go back to reference Jank S, et al. Sonographic investigation of the temporomandibular joint in patients with juvenile idiopathic arthritis: a pilot study. Arthritis Rheum. 2007;57(2):213–8.CrossRefPubMed Jank S, et al. Sonographic investigation of the temporomandibular joint in patients with juvenile idiopathic arthritis: a pilot study. Arthritis Rheum. 2007;57(2):213–8.CrossRefPubMed
4.
go back to reference Kuseler A, et al. Contrast enhanced magnetic resonance imaging as a method to diagnose early inflammatory changes in the temporomandibular joint in children with juvenile chronic arthritis. J Rheumatol. 1998;25(7):1406–12.PubMed Kuseler A, et al. Contrast enhanced magnetic resonance imaging as a method to diagnose early inflammatory changes in the temporomandibular joint in children with juvenile chronic arthritis. J Rheumatol. 1998;25(7):1406–12.PubMed
5.
go back to reference Pedersen TK, et al. Resorption of the temporomandibular condylar bone according to subtypes of juvenile chronic arthritis. J Rheumatol. 2001;28(9):2109–15.PubMed Pedersen TK, et al. Resorption of the temporomandibular condylar bone according to subtypes of juvenile chronic arthritis. J Rheumatol. 2001;28(9):2109–15.PubMed
6.
go back to reference Ringold S, Cron RQ. The temporomandibular joint in juvenile idiopathic arthritis: frequently used and frequently arthritic. Pediatr Rheumatol Online J. 2009;7:11.CrossRefPubMedPubMedCentral Ringold S, Cron RQ. The temporomandibular joint in juvenile idiopathic arthritis: frequently used and frequently arthritic. Pediatr Rheumatol Online J. 2009;7:11.CrossRefPubMedPubMedCentral
8.
go back to reference Weiss PF, et al. High prevalence of temporomandibular joint arthritis at disease onset in children with juvenile idiopathic arthritis, as detected by magnetic resonance imaging but not by ultrasound. Arthritis Rheum. 2008;58(4):1189–96.CrossRefPubMed Weiss PF, et al. High prevalence of temporomandibular joint arthritis at disease onset in children with juvenile idiopathic arthritis, as detected by magnetic resonance imaging but not by ultrasound. Arthritis Rheum. 2008;58(4):1189–96.CrossRefPubMed
9.
go back to reference de Sonnaville WFC, et al. Mandibular range of motion in children with juvenile idiopathic arthritis with and without clinically established temporomandibular joint involvement and in healthy children; a cross-sectional study. Pediatr Rheumatol Online J. 2021;19(1):106.CrossRefPubMedPubMedCentral de Sonnaville WFC, et al. Mandibular range of motion in children with juvenile idiopathic arthritis with and without clinically established temporomandibular joint involvement and in healthy children; a cross-sectional study. Pediatr Rheumatol Online J. 2021;19(1):106.CrossRefPubMedPubMedCentral
10.
go back to reference El Assar de la Fuente S, et al. Juvenile idiopathic arthritis and the temporomandibular joint: a comprehensive review. J Craniomaxillofac Surg. 2016;44(5):597–607.CrossRefPubMed El Assar de la Fuente S, et al. Juvenile idiopathic arthritis and the temporomandibular joint: a comprehensive review. J Craniomaxillofac Surg. 2016;44(5):597–607.CrossRefPubMed
11.
go back to reference Stoustrup P, et al. Cumulative incidence of orofacial manifestations in early juvenile idiopathic arthritis: a regional, three-year cohort study. Arthritis Care Res (Hoboken). 2020;72(7):907–16.CrossRefPubMed Stoustrup P, et al. Cumulative incidence of orofacial manifestations in early juvenile idiopathic arthritis: a regional, three-year cohort study. Arthritis Care Res (Hoboken). 2020;72(7):907–16.CrossRefPubMed
12.
go back to reference Assaf AT, et al. Is high-resolution ultrasonography suitable for the detection of temporomandibular joint involvement in children with juvenile idiopathic arthritis? Dentomaxillofac Radiol. 2013;42(3):20110379.CrossRefPubMedPubMedCentral Assaf AT, et al. Is high-resolution ultrasonography suitable for the detection of temporomandibular joint involvement in children with juvenile idiopathic arthritis? Dentomaxillofac Radiol. 2013;42(3):20110379.CrossRefPubMedPubMedCentral
13.
go back to reference Kristensen KD, et al. Clinical predictors of temporomandibular joint arthritis in juvenile idiopathic arthritis: a systematic literature review. Semin Arthritis Rheum. 2016;45(6):717–32.CrossRefPubMed Kristensen KD, et al. Clinical predictors of temporomandibular joint arthritis in juvenile idiopathic arthritis: a systematic literature review. Semin Arthritis Rheum. 2016;45(6):717–32.CrossRefPubMed
14.
go back to reference Keller H, et al. Is early TMJ involvement in children with juvenile idiopathic arthritis clinically detectable? Clinical examination of the TMJ in comparison with contrast enhanced MRI in patients with juvenile idiopathic arthritis. Pediatr Rheumatol Online J. 2015;13:56.CrossRefPubMedPubMedCentral Keller H, et al. Is early TMJ involvement in children with juvenile idiopathic arthritis clinically detectable? Clinical examination of the TMJ in comparison with contrast enhanced MRI in patients with juvenile idiopathic arthritis. Pediatr Rheumatol Online J. 2015;13:56.CrossRefPubMedPubMedCentral
15.
go back to reference Koos B, et al. Reliability of clinical symptoms in diagnosing temporomandibular joint arthritis in juvenile idiopathic arthritis. J Rheumatol. 2014;41(9):1871–7.CrossRefPubMed Koos B, et al. Reliability of clinical symptoms in diagnosing temporomandibular joint arthritis in juvenile idiopathic arthritis. J Rheumatol. 2014;41(9):1871–7.CrossRefPubMed
16.
go back to reference Stoustrup P, et al. Standardizing the clinical orofacial examination in juvenile idiopathic arthritis: an interdisciplinary, consensus-based short screening protocol. J Rheumatol. 2020;47(9):1397–404.CrossRefPubMed Stoustrup P, et al. Standardizing the clinical orofacial examination in juvenile idiopathic arthritis: an interdisciplinary, consensus-based short screening protocol. J Rheumatol. 2020;47(9):1397–404.CrossRefPubMed
17.
go back to reference Kellenberger CJ, et al. Temporomandibular joint atlas for detection and grading of juvenile idiopathic arthritis involvement by magnetic resonance imaging. Pediatr Radiol. 2018;48(3):411–26.CrossRefPubMed Kellenberger CJ, et al. Temporomandibular joint atlas for detection and grading of juvenile idiopathic arthritis involvement by magnetic resonance imaging. Pediatr Radiol. 2018;48(3):411–26.CrossRefPubMed
18.
go back to reference Tolend M, et al. Assessing the reliability of the OMERACT juvenile idiopathic arthritis magnetic resonance scoring system for temporomandibular Joints (JAMRIS-TMJ). J Clin Med. 2021;10(18):4047.CrossRefPubMedPubMedCentral Tolend M, et al. Assessing the reliability of the OMERACT juvenile idiopathic arthritis magnetic resonance scoring system for temporomandibular Joints (JAMRIS-TMJ). J Clin Med. 2021;10(18):4047.CrossRefPubMedPubMedCentral
19.
go back to reference Tolend MA, et al. Toward establishing a standardized magnetic resonance imaging scoring system for temporomandibular joints in juvenile idiopathic arthritis. Arthritis Care Res (Hoboken). 2018;70(5):758–67.CrossRefPubMed Tolend MA, et al. Toward establishing a standardized magnetic resonance imaging scoring system for temporomandibular joints in juvenile idiopathic arthritis. Arthritis Care Res (Hoboken). 2018;70(5):758–67.CrossRefPubMed
20.
go back to reference Vaid YN, et al. Imaging of the temporomandibular joint in juvenile idiopathic arthritis. Arthritis Care Res (Hoboken). 2014;66(1):47–54.CrossRefPubMed Vaid YN, et al. Imaging of the temporomandibular joint in juvenile idiopathic arthritis. Arthritis Care Res (Hoboken). 2014;66(1):47–54.CrossRefPubMed
21.
go back to reference Koos B, et al. Classification of temporomandibular joint erosion, arthritis, and inflammation in patients with juvenile idiopathic arthritis. J Orofac Orthop. 2013;74(6):506–19.CrossRefPubMed Koos B, et al. Classification of temporomandibular joint erosion, arthritis, and inflammation in patients with juvenile idiopathic arthritis. J Orofac Orthop. 2013;74(6):506–19.CrossRefPubMed
22.
go back to reference Müller L, et al. Early diagnosis of temporomandibular joint involvement in juvenile idiopathic arthritis: a pilot study comparing clinical examination and ultrasound to magnetic resonance imaging. Rheumatology (Oxford). 2009;48(6):680–5.CrossRefPubMed Müller L, et al. Early diagnosis of temporomandibular joint involvement in juvenile idiopathic arthritis: a pilot study comparing clinical examination and ultrasound to magnetic resonance imaging. Rheumatology (Oxford). 2009;48(6):680–5.CrossRefPubMed
23.
go back to reference Zwir LF, et al. Is power Doppler ultrasound useful to evaluate temporomandibular joint inflammatory activity in juvenile idiopathic arthritis? Clin Rheumatol. 2020;39(4):1237–40.CrossRefPubMed Zwir LF, et al. Is power Doppler ultrasound useful to evaluate temporomandibular joint inflammatory activity in juvenile idiopathic arthritis? Clin Rheumatol. 2020;39(4):1237–40.CrossRefPubMed
24.
go back to reference Melchiorre D, et al. Sonographic evaluation of the temporomandibular joints in juvenile idiopathic arthritis. J Ultrasound. 2010;13(1):34–7.CrossRefPubMed Melchiorre D, et al. Sonographic evaluation of the temporomandibular joints in juvenile idiopathic arthritis. J Ultrasound. 2010;13(1):34–7.CrossRefPubMed
25.
go back to reference Kirkhus E, et al. Temporomandibular joint involvement in childhood arthritis: comparison of ultrasonography-assessed capsular width and MRI-assessed synovitis. Dentomaxillofac Radiol. 2016;45(8):20160195.CrossRefPubMedPubMedCentral Kirkhus E, et al. Temporomandibular joint involvement in childhood arthritis: comparison of ultrasonography-assessed capsular width and MRI-assessed synovitis. Dentomaxillofac Radiol. 2016;45(8):20160195.CrossRefPubMedPubMedCentral
26.
go back to reference Hechler BL, et al. Ultrasound versus magnetic resonance imaging of the temporomandibular joint in juvenile idiopathic arthritis: a systematic review. Int J Oral Maxillofac Surg. 2018;47(1):83–9.CrossRefPubMed Hechler BL, et al. Ultrasound versus magnetic resonance imaging of the temporomandibular joint in juvenile idiopathic arthritis: a systematic review. Int J Oral Maxillofac Surg. 2018;47(1):83–9.CrossRefPubMed
27.
go back to reference Marino A, De Lucia O, Caporali R. Role of ultrasound evaluation of temporomandibular joint in juvenile idiopathic arthritis: a systematic review. Children (Basel). 2022;9(8):1254.PubMed Marino A, De Lucia O, Caporali R. Role of ultrasound evaluation of temporomandibular joint in juvenile idiopathic arthritis: a systematic review. Children (Basel). 2022;9(8):1254.PubMed
28.
go back to reference Petty RE, et al. International League of Associations for Rheumatology classification of juvenile idiopathic arthritis: second revision, Edmonton, 2001. J Rheumatol. 2004;31(2):390–2.PubMed Petty RE, et al. International League of Associations for Rheumatology classification of juvenile idiopathic arthritis: second revision, Edmonton, 2001. J Rheumatol. 2004;31(2):390–2.PubMed
29.
go back to reference Kellenberger CJ, Arvidsson LZ, Larheim TA. Magnetic resonance imaging of temporomandibular joints in juvenile idiopathic arthritis. Semin Orthodont. 2015;21(2):111–20.CrossRef Kellenberger CJ, Arvidsson LZ, Larheim TA. Magnetic resonance imaging of temporomandibular joints in juvenile idiopathic arthritis. Semin Orthodont. 2015;21(2):111–20.CrossRef
30.
go back to reference Kirkhus E, et al. Disk abnormality coexists with any degree of synovial and osseous abnormality in the temporomandibular joints of children with juvenile idiopathic arthritis. Pediatr Radiol. 2016;46(3):331–41.CrossRefPubMed Kirkhus E, et al. Disk abnormality coexists with any degree of synovial and osseous abnormality in the temporomandibular joints of children with juvenile idiopathic arthritis. Pediatr Radiol. 2016;46(3):331–41.CrossRefPubMed
31.
go back to reference Tonni I, et al. An ultrasound protocol for temporomandibular joint in juvenile idiopathic arthritis: a pilot study. Dentomaxillofac Radiol. 2021;50(8):20200399.CrossRefPubMedPubMedCentral Tonni I, et al. An ultrasound protocol for temporomandibular joint in juvenile idiopathic arthritis: a pilot study. Dentomaxillofac Radiol. 2021;50(8):20200399.CrossRefPubMedPubMedCentral
32.
go back to reference Emshoff R, et al. Are high-resolution ultrasonographic signs of disc displacement valid? J Oral Maxillofac Surg. 2002;60(6):623–8.CrossRefPubMed Emshoff R, et al. Are high-resolution ultrasonographic signs of disc displacement valid? J Oral Maxillofac Surg. 2002;60(6):623–8.CrossRefPubMed
33.
go back to reference Elias FM, et al. Ultrasonographic findings in normal temporomandibular joints. Braz Oral Res. 2006;20(1):25–32.CrossRefPubMed Elias FM, et al. Ultrasonographic findings in normal temporomandibular joints. Braz Oral Res. 2006;20(1):25–32.CrossRefPubMed
Metadata
Title
Temporomandibular joint involvement in patients with Juvenile Idiopathic Arthritis: comparison of ultrasonography and magnetic resonance imaging in assessing the periarticular space width
Authors
Ingrid Tonni
Giulia Fossati
Maria Luisa Garo
Maria Grazia Piancino
Marco Cattalini
Luca Visconti
Andrea Borghesi
Publication date
03-07-2023
Publisher
Springer Nature Singapore
Published in
Oral Radiology / Issue 4/2023
Print ISSN: 0911-6028
Electronic ISSN: 1613-9674
DOI
https://doi.org/10.1007/s11282-023-00696-5

Other articles of this Issue 4/2023

Oral Radiology 4/2023 Go to the issue