Diagnosis of juvenile idiopathic arthritis with asymptomatic involvement of the temporomandibular joint: A case report

Spec Care Dentist. 2023 Mar;43(2):267-275. doi: 10.1111/scd.12756. Epub 2022 Jul 13.

Abstract

Juvenile idiopathic arthritis (JIA) is a broad term that describes a group of heterogeneous rheumatologic diseases, mainly characterized by inflammation in the joints of children and young people up to 16 years of age. Its etiology is still not well understood and the diagnosis, essentially clinical, begins with the exclusion of other joint diseases. When the disease affects the temporomandibular joint, diagnosis is a challenge, as many patients are asymptomatic. The objective of this paper is to present a case of JIA with severe involvement of the temporomandibular joint and to discuss the clinical, radiographic, laboratory findings and the importance of early diagnosis. The lack of diagnosis of active arthritis in the temporomandibular joint in patients with JIA can cause irreversible effects such as micrognathia, malocclusion and reduced maximum mouth opening. Early diagnosis of temporomandibular joint involvement in JIA is important and needs to be investigated early in the clinical manifestation of systemic disease. Laboratory tests and clinical history are important to define treatment and prognosis, but not to predict temporomandibular joint arthritis. Imaging exams are important diagnostic tools to identify morphological changes in soft and hard tissues of the temporomandibular joint.

Keywords: case report; diagnosis; juvenile idiopathic arthritis; magnetic resonance imaging; temporomandibular joint; tomography.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Arthritis, Juvenile* / complications
  • Arthritis, Juvenile* / diagnosis
  • Child
  • Humans
  • Inflammation / complications
  • Magnetic Resonance Imaging / adverse effects
  • Temporomandibular Joint / anatomy & histology
  • Temporomandibular Joint / diagnostic imaging
  • Temporomandibular Joint Disorders* / diagnostic imaging
  • Temporomandibular Joint Disorders* / etiology