Premium
Temporomandibular joint magnetic resonance imaging findings in adolescents with anterior disk displacement compared to those with juvenile idiopathic arthritis
Author(s) -
Kellenberger Christian J.,
Bucheli Jeannine,
SchroederKohler Silke,
Saurenmann Rotraud K.,
Colombo Vera,
Ettlin Dominik A.
Publication year - 2019
Publication title -
journal of oral rehabilitation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.991
H-Index - 93
eISSN - 1365-2842
pISSN - 0305-182X
DOI - 10.1111/joor.12720
Subject(s) - medicine , condyle , temporomandibular joint , magnetic resonance imaging , arthritis , deformity , joint effusion , dentistry , orthodontics , surgery , radiology
Summary Background Deformation of the mandibular condyle can be associated with anterior disk displacement ( ADD ) or involvement of the temporomandibular joint ( TMJ ) by juvenile idiopathic arthritis ( JIA ). Diagnostic differentiation is critical for proper management. Objectives To compare morphology and inflammation between TMJ s with ADD and JIA . Methods Retrospective assessment of contrast‐enhanced TMJ MRI in 18 adolescents (15 female, mean age 15.1 ± 1.9 years) with ADD and age‐ and gender‐matched patients with JIA . Articular disk findings, inflammatory signs and osseous morphology were compared. Results In the ADD group, 31 of 36 disks were displaced. In total, 28 of 31 displaced disks showed thickening of the bilaminar zone. In JIA patients, the disks were mainly flattened (19/36), centrally perforated (12/36) and/or anteriorly displaced (2/36). In total, 19 of 31 TMJ s with ADD showed various degrees of inflammation, with joint effusion, synovial thickening and joint enhancement not significantly different from JIA patients. Osseous deformity was present in 27 of 31 TMJ s with ADD , with frequent erosions in both groups ( ADD 25/31; JIA 32/36, P = 0.55) but lower grades of condylar and temporal bone flattening than in JIA ( P ≤ 0.001). Glenoid fossa depth was preserved in 28 of 31 joints with ADD and decreased in 26 of 36 joints with JIA ( P < 0.0001). Mandibular ramus height was decreased in both groups. Conclusion In adolescents, inflammatory signs are common MRI findings in symptomatic TMJ s with ADD and thus should not be considered diagnostic for JIA involvement. In this cohort, both entities had high rates of condylar deformity, while TMJ s with ADD showed a better‐preserved and often normal shape of the glenoid fossa.