MR EVALUATION OF THE TEMPOROMANDIBULAR-JOINT IN JUVENILE RHEUMATOID-ARTHRITIS

Temporomandibular joint (TMJ) disease is uncommon in children but freq uently occurs in juvenile rheumatoid arthritis (JRA). Involvement is o ften asymptomatic; however, it can lead to growth disturbances and fac ial deformity. Thirty TMJs in 15 children (11 girls and 4 boys aged 3. 5-18 years) with JRA were evaluated clinically and by MRI. Plain films were reviewed when available. Magnetic resonance imaging parameters i ncluded T1-weighted and in some cases T2-weighted or gradient recall e cho sequences. We assessed condylar configuration, glenoid fossa chang es, presence of erosions, disk abnormality, range of motion, and prese nce of joint effusions or pannus. Abnormalities included cortical eros ions (n = 19), disk thinning (n = 18), and perforation (n = 2). Reduct ion of joint movement (n = 20), joint locking (n = 3), and pannus/effu sions (n = 5) were also found. Magnetic resonance imaging is a useful technique for the detection of TMJ involvement in JRA. Early detection and therapeutic intervention may lessen or prevent subsequent deformi ties.