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Published in: Pediatric Rheumatology 1/2015

Open Access 01-12-2015 | Research article

Temporomandibular joint steroid injections in patients with juvenile idiopathic arthritis: an observational pilot study on the long-term effect on signs and symptoms

Authors: Peter Stoustrup, Kasper Dahl Kristensen, Annelise Küseler, Thomas Klit Pedersen, Troels Herlin

Published in: Pediatric Rheumatology | Issue 1/2015

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Abstract

Background

Temporomandibular joint (TMJ) inflammation in patients with juvenile idiopathic arthritis (JIA) can lead to orofacial pain and malfunction of the TMJ. Intra-articular corticosteroid injections (IACI) have been suggested as a treatment modality against TMJ arthritis-related orofacial signs and symptoms. However, knowledge of the effect-durability of these injections remains unanswered. The aim of this pilot study was to evaluate the short and long-term effects of IACI on orofacial symptoms in a prospective observational study based on pre-specified clinical examination standards.

Methods

Thirteen patients with JIA and arthritis-related orofacial signs and symptoms were included in this prospective pilot study (median 17.2 years, IQR 15–18.4 years). All patients received TMJ IACI (11 bilateral and two unilateral) due to an insufficient response to previous pain-management treatments. Three standardized clinical examinations were carried out: T1 prior to treatment, T2 short-term follow-up (mean 34 days post-treatment), T3 long-term follow-up (mean 333 days post-treatment).

Results

Significant pain reduction was observed at the short-term follow-up (T2). Resolution of orofacial pain after IACI was a rare finding at T2. Generally, the pain significantly worsened between T2 and T3 examinations. The reported pain levels rose between T2 and T3 indicating a loss of effect of the IACI at the long-term follow-up examination (T3). Non-significant improvements in TMJ mobility were observed at T2 and T3.

Conclusion

Our results suggest a palliative (not curative) effect of IACI for TMJ arthritis-related orofacial symptoms in patients with long-term orofacial pain complaints. The short-term improvements in signs and symptoms were partly resolved at the long-term follow-up.
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Metadata
Title
Temporomandibular joint steroid injections in patients with juvenile idiopathic arthritis: an observational pilot study on the long-term effect on signs and symptoms
Authors
Peter Stoustrup
Kasper Dahl Kristensen
Annelise Küseler
Thomas Klit Pedersen
Troels Herlin
Publication date
01-12-2015
Publisher
BioMed Central
Published in
Pediatric Rheumatology / Issue 1/2015
Electronic ISSN: 1546-0096
DOI
https://doi.org/10.1186/s12969-015-0060-6

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