A prospective study of magnetic resonance and radiographic imaging in relation to symptoms and clinical findings of the temporomandibular joint in children with juvenile idiopathic arthritis.
A prospective study of magnetic resonance and radiographic imaging in relation to symptoms and clinical findings of the temporomandibular joint in children with juvenile idiopathic arthritis.
复制标题
一项磁共振和放射成像与幼年特发性关节炎儿童颞下颌关节症状和临床表现相关的前瞻性研究。
作者：
T. Pedersen;A. Küseler;J. Gelineck;T. Herlin
目的
在幼年特发性关节炎（JIA）患者中，颞下颌关节（TMJ）受累是严重生长障碍的常见原因。生长偏差的程度取决于发病年龄和颞下颌关节炎的持续时间。颞下颌关节炎很难在早期诊断，因为与该关节相关的症状和临床发现相对较少。病理过程可以影响生长很久之前，放射学变化被发现。我们调查了颞下颌关节炎与症状和临床表现之间的关系，以提出诊断颞下颌关节炎的临床常规。我们还描述了颞下颌关节炎的过程中常用的放射学方法与MRI。
方法
对15例JIA患儿每隔6个月进行4次临床检查、MRI扫描和正射断层扫描（OPG）检查，以确定是否有颞下颌关节受累。在基线时，10名健康儿童作为对照组。
结果
与对照组相比，患者报告更多的无法咀嚼和张开嘴。关节炎组的髁突平移和下颌运动范围减少。平移减少与OPG和MRI上观察到的髁突变化相关。MRI在随访髁突随时间的变化方面上级OPG，几乎所有关节均检测到炎症。
结论
OPG不能被推荐用于诊断或跟踪TMJ的变化过程。我们提倡记录髁突平移和下颌活动度作为当前的临床常规，以发现早期TMJ关节炎，而我们研究中经常使用的OPG是一种不确定的方法。
OBJECTIVE
In patients with juvenile idiopathic arthritis (JIA) temporomandibular joint (TMJ) involvement is a common cause of severe growth disturbances. Extent of growth deviation depends on age of onset and duration of arthritis in the TMJ. TMJ arthritis is difficult to diagnose at an early stage since relatively few symptoms and clinical findings are related to this joint. The pathologic process can affect growth long before radiographic changes are seen. We investigated the relationship between TMJ arthritis and symptoms and clinical findings to suggest a clinical routine for diagnosing TMJ arthritis. We also describe the course of TMJ arthritis in relation to a commonly used radiographic method versus MRI.
METHODS
Fifteen children with JIA were examined 4 times at 6 month intervals for TMJ involvement by clinical examination, MRI-scanning, and orthopantomograms (OPG). At baseline, 10 healthy children served as a control group.
RESULTS
Patients reported more inability to chew and open their mouth than the control group. Translation of the condyle and range of mandibular movements were diminished in the arthritis group. Decreased translation was correlated to condylar changes seen on both OPG and MRI. MRI was superior to OPG in following changes of the condyle over time, and inflammation was detected in nearly all joints.
CONCLUSION
OPG cannot be recommended for diagnosis or to follow the course of changes in the TMJ. We advocate recording condylar translation and mandibular range of motion as a current clinical routine to find early TMJ arthritis in contrast to the often used OPG performed in our study, which was an uncertain method.
DOI：
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发表时间：
1998-10
期刊：
The Journal of rheumatology
影响因子：
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作者：
R. Petty;T. Southwood;J. Baum;E. Bhettay;D. Glass;P. Manners;J. Maldonado-Cocco;M. Suarez‐Almazor-M.-Suarez‐Alm
通讯作者：
R. Petty;T. Southwood;J. Baum;E. Bhettay;D. Glass;P. Manners;J. Maldonado-Cocco;M. Suarez‐Almazor-M.-Suarez‐Alm