CONTRAST-ENHANCED MAGNETIC-RESONANCE-IMAGING AS A METHOD TO DIAGNOSE EARLY INFLAMMATORY CHANGES IN THE TEMPOROMANDIBULAR-JOINT IN CHILDREN WITH JUVENILE CHRONIC ARTHRITIS

Objective. Recent studies have stressed early diagnosis of temporomand ibular joint (TMJ) involvement in children with juvenile chronic arthr itis (JCA) to initiate treatment before destruction of the condylar he ad and growth alterations take place. TMI involvement is often asympto matic, but studies with contrast enhanced magnetic resonance imaging ( MRI) in other joints have shown that it is possible to detect the earl y inflammatory changes. Methods. Thirty TR?IJ in 15 children with newl y diagnosed JCA (mean age 12.0 years) were examined clinically, with r adiographs and with MRT enhanced with gadolinium diethylene thiamine p entaacetic acid (Gd-DTPA). A control group of 10 healthy children (mea n age 11.5 yrs) were examined clinically and with MRI. The MRI variabl es included T1 weighted images before and after administration of Gd-D TPA with and without fat suppression. Results. MRI enhanced with Gd-DT PA indicated inflammatory activity in 87% of the patients. Conventiona l MRI without contrast medium proved to be insignificant in diagnosing early inflammatory changes. Conclusion. Enhanced MRI is very efficien t in diagnosing early inflammatory changes of the TMJ and is a more se nsitive method than the clinical examination and radiographs.