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Imaging of temporomandibular joint abnormalities in juvenile idiopathic arthritis with a focus on developing a magnetic resonance imaging protocol

  • Minisymposium: Juvenile Idiopathic Arthritis
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Abstract

Inflammation and damage in the temporomandibular joint (TMJ) often develop without clinical symptoms but can lead to severe facial growth abnormalities and impaired health-related quality of life, making early diagnosis of TMJ changes crucial to identify. Inflammatory and osteochondral changes detectable through magnetic resonance imaging (MRI) occur in TMJs of approximately 40% of children with juvenile idiopathic arthritis (JIA), and no other imaging modality or physical method of examination can reliably detect these changes. Therefore contrast-enhanced MRI is the diagnostic standard for diagnosis and interval monitoring of JIA. However the specific usage of MRI for TMJ arthritis is not standardized at present. There is a recognized need for a consensus effort toward standardization of an imaging protocol with required and optional sequences to improve detection of pathological changes and shorten study time. Such a consensus imaging protocol is important for providing maximum information with minimally necessary sequences in a way that allows inter-site comparison of results of clinical trials and improved clinical management. In this paper we describe the challenges of TMJ imaging and present expert-panel consensus suggestions for a standardized TMJ MRI protocol.

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Acknowledgments

The authors thank Prof. Yoginder Vaid for his participation and valuable feedback in the initial stages of the consensus imaging protocol development meetings, and also Prof. Karen Rosendahl for her constructive comments to the manuscript. Profs. Kellenberger and Larheim contributed equally as senior authors of this article.

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Authors and Affiliations

  1. Department of Medical Imaging, Children’s Hospital of Eastern Ontario, Ottawa, ON, Canada

    Elka Miller

  2. Department of Diagnostic Imaging, Hospital Sant Joan de Deu, Barcelona, Spain

    Emilio J. Inarejos Clemente

  3. Pediatric Rheumatology Research Institute, Bad Bramstedt, Germany

    Nikolay Tzaribachev

  4. Austin Radiological Association, Austin, TX, USA

    Saurabh Guleria

  5. Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, ON, Canada

    Mirkamal Tolend, Jennifer Stimec & Andrea S. Doria

  6. Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children, 686 Bay Street, 08.9840-L4, Toronto, ON, M5G 1A4, Canada

    Mirkamal Tolend

  7. Department of Radiology, Nemours Children’s Health System, Orlando, FL, USA

    Arthur B. Meyers

  8. Department of Pediatric Radiology, Radiologisches Institut, Olgahospital Klinikum Stuttgart, Stuttgart, Germany

    Thekla von Kalle

  9. Department of Orthodontics, University Hospital Tübingen, Tübingen, Germany

    Bernd Koos

  10. School of Medical Science, University of Campinas, Campinas, Brazil

    Simone Appenzeller

  11. Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo, Oslo, Norway

    Linda Z. Arvidsson & Tore A. Larheim

  12. Department of Radiology and Nuclear Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway

    Eva Kirkhus

  13. Department of Diagnostic Imaging, University Children’s Hospital, Zürich, Switzerland

    Christian J. Kellenberger

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  1. Elka Miller
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  2. Emilio J. Inarejos Clemente
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Correspondence to Mirkamal Tolend.

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Miller, E., Inarejos Clemente, E.J., Tzaribachev, N. et al. Imaging of temporomandibular joint abnormalities in juvenile idiopathic arthritis with a focus on developing a magnetic resonance imaging protocol. Pediatr Radiol 48, 792–800 (2018). https://doi.org/10.1007/s00247-017-4005-8

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  • DOI: https://doi.org/10.1007/s00247-017-4005-8

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