Skip to main content
SpringerLink
Log in

Is power Doppler ultrasound useful to evaluate temporomandibular joint inflammatory activity in juvenile idiopathic arthritis?

  • Original Article
  • Published:
Clinical Rheumatology Aims and scope Submit manuscript

Abstract

Objective

To evaluate the effectiveness of power Doppler ultrasound (US) in assessing the temporomandibular joint (TMJ) involvement in juvenile idiopathic arthritis (JIA) patients using contrast-enhanced magnetic resonance imaging (MRI) as the reference standard.

Methods

We evaluated the US and MRI examinations of the TMJs from 92 JIA patients. These exams were done and scored for inflammatory activity on the same date.

Results

There were considerable differences between the US and MRI findings, with MRI detecting more effectively the TMJ involvement. No association was found between synovial inflammation obtained using power Doppler US to assess synovial vascularity determined by US images and synovial enhancement determined by MRI images. US had very poor sensitivity and very low positive predictive value to detect TMJ arthritis in JIA patients compared with MRI as the reference standard.

Conclusions

Power Doppler US cannot replace MRI for the detection of TMJ inflammatory involvement in JIA patients.

Key Points

• The early diagnosis of TMJ involvement in JIA patients is very important in order to prevent disturbances in the mandibular growth.

• Power Doppler US could be a useful diagnostic tool as a screening exam to identify inflammatory activity in this joint.

• However, power Doppler US did not show to have this function and cannot replace MRI for the detection of TMJ inflammatory involvement in JIA patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Petty RE, Southwood TR, Manners P, Baum J, Glass DN, Goldenberg J et al (2001) International League of Associations for Rheumatology classification of juvenile idiopathic arthritis: second revision, Edmonton. J Rheumatol 31:390–392

    Google Scholar 

  2. Küseler A, Pedersen TK, Herlin T, Gelineck J (1998) Contrast enhanced magnetic resonance imaging as a method to diagnose early inflammatory changes in the temporomandibular joint in children with juvenile chronic arthritis. J Rheumatol 25:1406–1412

    PubMed  Google Scholar 

  3. Pedersen TK, Kuseler A, Gelineck J, Herlin T (2008) 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. J Rheumatol 35:1668–1675

    PubMed  Google Scholar 

  4. Chauvin NA, Doria AS (2017) Ultrasound imaging of synovial inflammation in juvenile idiopathic arthritis. Pediatr Radiol 47:1160–1170

    Article  Google Scholar 

  5. Weiss PF, Arabshahi B, Johnson A, Bilaniuk LT, Zarnow D, Cahill AM et al (2008) High prevalence of temporomandibular joint arthritis at disease onset in children with juvenile idiopathic arthritis, as detected by magnetic resonance imaging but not by ultrasound. Arthritis Rheum 58:1189–1196

    Article  Google Scholar 

  6. Melchiorre D, Falcini F, Kaloudi O, Bandinelli F, Nacci F, MatucciCerinic M (2010) Sonographic evaluation of the temporomandibular joints in juvenile idiopathic arthritis. J Ultrasound 13:34–37

    Article  CAS  Google Scholar 

  7. Johnson K (2006) Imaging of juvenile idiopathic arthritis. Pediatr Radiol 36:743–758

    Article  Google Scholar 

  8. Szkudlarek M, Narvestad E, Klarlund M, Court-Payen M, Thomsen HS, Ostergaard M (2004) Ultrasonography of the metatarsophalangeal joints in rheumatoid arthritis: comparison with magnetic resonance imaging, conventional radiography, and clinical examination. Arthritis Rheum 50:2103–2112

    Article  Google Scholar 

  9. Jank S, Haase S, Strobl H, Michels H, Hafner R, Missmann M et al (2007) Sonographic investigation of the temporomandibular joint in patients with juvenile idiopathic arthritis: a pilot study. Arthritis Rheum 57:213–218

    Article  Google Scholar 

  10. Müller L, Kellenberger CJ, Cannizzaro E, Ettlin D, Schraner T, Bolt IB et al (2009) Early diagnosis of temporomandibular joint involvement in juvenile idiopathic arthritis: a pilot study comparing clinical examination and ultrasound to magnetic resonance imaging. Rheumatology (Oxford) 48:680–685

    Article  Google Scholar 

  11. Vilanova JC, Barceló J, Puig J, Remollo S, Nicolau C, Bru C (2007) Diagnostic imaging: magnetic resonance imaging, computed tomography, and ultrasound. Semin Ultrasound CT MR 28(3):184–191

    Article  Google Scholar 

  12. Tomas X, Pomes J, Berenguer J, Quinto L, Nicolau C, Mercader JM, Castro V (2006) MR imaging of temporomandibular joint dysfunction: a pictorial review. Radiographics. 26(3):765–781

    Article  Google Scholar 

  13. Granata V, Cascella M, Fusco R, dell’Aprovitola N, Catalano O, Filice S, Schiavone V, Izzo F, Cuomo A, Petrillo A (2016) Immediate adverse reactions to gadolinium-based MR contrast media: a retrospective analysis on 10,608 examinations. Biomed Res Int 2016:3918292

    PubMed  PubMed Central  Google Scholar 

  14. Khawaja AZ, Cassidy DB, Al Shakarchi J, McGrogan DG, Inston NG, Jones RG (2015) Revisiting the risks of MRI with gadolinium based contrast agents-review of literature and guidelines. Insights Imaging 6(5):553–558

    Article  Google Scholar 

  15. Olchowy C, Cebulski K, Łasecki M, Chaber R, Olchowy A, Kałwak K, Zaleska-Dorobisz U (2017) The presence of the gadolinium-based contrast agent depositions in the brain and symptoms of gadolinium neurotoxicity - a systematic review. PLoS One 12(2):e0171704

    Article  Google Scholar 

  16. Rossi Espagnet MC, Bernardi B, Pasquini L, Figà-Talamanca L, Tomà P, Napolitano A (2017) Signal intensity at unenhanced T1-weighted magnetic resonance in the globus pallidus and dentate nucleus after serial administrations of a macrocyclic gadolinium-based contrast agent in children. Pediatr Radiol 47(10):1345–1352

    Article  Google Scholar 

  17. Assaf AT, Kahl-Nieke B, Feddersen J, Habermann CR (2013) Is high-resolution ultrasonography suitable for the detection of temporomandibular joint involvement in children with juvenile idiopathic arthritis? Dentomaxillofac Radiol 42:20110379

    Article  CAS  Google Scholar 

  18. Damasio MB, Malattia C, Martini A, Tomà P (2010) Synovial and inflammatory diseases in childhood: role of new imaging modalities in the assessment of patients with juvenile idiopathic arthritis. Pediatr Radiol 40:985–998

    Article  Google Scholar 

  19. Zwir LM, Terreri MT, Sousa SA, Fernandes AR, Guimarães AS, Hilário MO (2015) Are temporomandibular joint signs and symptoms associated with magnetic resonance imaging findings in juvenile idiopathic arthritis patients? A longitudinal study. Clin Rheumatol 34:2057–2063

    Article  Google Scholar 

Download references

Funding

This study was financially supported by the Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP 07/56228-9).

Author information

Authors and Affiliations

  1. Department of Pediatrics, UNIFESP, São Paulo, Brazil

    Liete Figueiredo Zwir, Maria Teresa Terreri & Wellington D. R. Rodrigues

  2. Department of Diagnostic Imaging, UNIFESP, São Paulo, Brazil

    Adham do Amaral e Castro & Artur Rocha Corrêa Fernandes

Authors
  1. Liete Figueiredo Zwir
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Maria Teresa Terreri
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Adham do Amaral e Castro
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Wellington D. R. Rodrigues
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Artur Rocha Corrêa Fernandes
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Liete Figueiredo Zwir.

Ethics declarations

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Disclosures

None.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Zwir, L.F., Terreri, M.T., do Amaral e Castro, A. et al. Is power Doppler ultrasound useful to evaluate temporomandibular joint inflammatory activity in juvenile idiopathic arthritis?. Clin Rheumatol 39, 1237–1240 (2020). https://doi.org/10.1007/s10067-019-04731-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10067-019-04731-x

Keywords

Search

Navigation