TEMPOROMANDIBULAR JOINT IN JUVENILE IDIOPATHIC ARTRITIS: AN IMAGING STUDY AND ERGONOMIC CONSIDERATIONS

Temporomandibular joint (TMJ) may be involved in different JIA subtypes, with a prevalence ranging between 40 to 70%, leading to various degrees of disability, mainly related to pain, inflammation, reduced mandibular mobility, damage of the condyle and secondary masticatory muscle impairment. The aim of the present work was to describe TMJ involvement in different subtypes of JIA, based on a complex epidemiological, clinical and imaging approach. We performed a prospective observational study on 22 consecutive JIA attending an academic rheumatology department. Imagistic assessments comprised: (i) an X-ray of vertebral (lumbar and cervical spine) as well as peripheral joints in order to support the diagnosis and to evaluate the stage of the disease; (ii) a TMJ ultrasonography; (iii) a TMJ CT scan; and (iv) a CBCT. The following parameters were evaluated in our patients: demographics and general characteristics (sex, age, duration of disease, JIA onset); TMJ-related data e.g. spontaneous or provoked unilateral or bilateral TMJ pain measured on a visual analog scale (VAS), accompanied by morning stiffness or stiffness after rest; clicking and crepitation were noted in the context mandible mobilization; muscle contracture (masseter, temporal, internal pterygoid); parafunctions; TMJ imaging; dental, gingival and occlusal status. TMJ involvement is classically described among JIA patients, presenting with various clinical signs and symptoms and different degrees of inflammation and condylar damage.