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Temporomandibular joint (TMJ) arthritis on magnetic resonance imaging (MRI), but not ultrasound, is often found at the onset of juvenile idiopathic arthritis (JIA), according to Pennsylvania-based researchers. "Temporomandibular joint (TMJ) arthritis on magnetic resonance imaging (MRI), but not ultrasound, is often found at the onset of juvenile idiopathic arthritis (JIA), according to Pennsylvania-based researchers.

In fact, lead investigator Dr. Pamela F. Weiss told Reuters Health that "given the high prevalence of TMJ disease in new-onset JIA, pediatric rheumatologists should consider instituting universal screening for TMJ arthritis with MRI in newly diagnosed JIA patients."

As reported in the April issue of Arthritis and Rheumatism, Dr. Weiss of Children's Hospital of Philadelphia and colleagues prospectively evaluated 32 children with newly diagnosed JIA. Both MRI and ultrasound were employed.

MRI identified acute TMJ arthritis in 24 of the patients (75 per cent). Ultrasound did not identify any cases. Of patients with acute TMJ arthritis, 71 per cent were asymptomatic and 63 per cent had normal findings on jaw examination. Corticosteroid injection improved maximal incisal opening in 56 per cent of the patients with acute disease.

MRI detected chronic TMJ arthritic changes in 69 per cent of the patients, whereas only 28 per cent were diagnosed by ultrasound.

"The next step," concluded Dr. Weiss, "is to determine how often and how physicians should screen for activity and resolution of TMJ disease."