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Pediatric Radiology

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01-03-2015 | Original Article

Early detection of temporomandibular joint arthritis in children with juvenile idiopathic arthritis – the role of contrast-enhanced MRI

Authors: Thekla von Kalle, Tina Stuber, Peter Winkler, Jan Maier, Toni Hospach

Published in: Pediatric Radiology | Issue 3/2015

Abstract

Background

Early treatment of temporomandibular joint (TMJ) arthritis is crucial in children with juvenile idiopathic arthritis (JIA) to prevent permanent functional impairment. As involvement of TMJs is often asymptomatic, contrast-enhanced MRI is regarded as the most sensitive noninvasive diagnostic tool.

Objective

To evaluate the degree of contrast enhancement in TMJs of children and adolescents with JIA in comparison to normal controls from a previous study.

Materials and methods

Dynamic contrast-enhanced MRI of 50 children and adolescents with JIA (6.3 to 18 years of age; mean: 12 years) were retrospectively analysed. We assessed morphological abnormalities and postcontrast time-intensity curves of the soft joint tissue and the mandibular condyle. Ratios were calculated to quantify postcontrast signal intensities (SI) in relation to precontrast SI at initial (1 min postcontrast) and maximum (6 min postcontrast) increase.

Results

Time-intensity curves followed similar biphasic patterns in normal and pathological joints. In joints with morphological signs of arthritis, mean SI ratios were on average higher than in normal joints of the reference group, but ranges of values widely overlapped. Arthritis: mean initial increase of SI 62% (±2 S.D. 18-105%), mean maximum SI 106% higher than precontrast (±2 S.D. 46-166%). Normal: mean initial increase of SI 49% (±2 S.D. 14- 85%), mean maximum of SI 73% (±2 S.D. 23-123%).

Conclusions

Given this considerable overlap of results in dynamic contrast-enhanced MRI, the degree of contrast enhancement alone did not allow differentiation between TMJs with and without signs of inflammation. Thickening of the soft joint tissue seems to remain the earliest sign to reliably indicate TMJ arthritis.

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Title: Early detection of temporomandibular joint arthritis in children with juvenile idiopathic arthritis – the role of contrast-enhanced MRI
Authors: Thekla von Kalle
Tina Stuber
Peter Winkler
Jan Maier
Toni Hospach
Publication date: 01-03-2015
Publisher: Springer Berlin Heidelberg
Published in: Pediatric Radiology / Issue 3/2015
Print ISSN: 0301-0449
Electronic ISSN: 1432-1998
DOI: https://doi.org/10.1007/s00247-014-3143-5

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Early detection of temporomandibular joint arthritis in children with juvenile idiopathic arthritis – the role of contrast-enhanced MRI

Abstract

Background

Objective

Materials and methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Objective

Materials and methods

Results

Conclusions

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