Background Juvenile Idiopathic Arthritis (JIA) has been shown to involve frequently the temporo-mandibular joint (TMJ). An important prognostic aspect is to diagnose and treat it promptly.
Objectives To evaluate in a consecutive JIA patients (pts) cohort, regularly screened from year 2000 to 2014, the predictive factors of the TMJ involvement.
Methods 230 consecutive pts (152 females, 78 males) affected by JIA according to ILAR classification, 164 oligoarthritis, 4 polyarthritis rheumatoid factor (RF) +, 34 polyarthritis RF-, 22 systemic onset JIA (soJIA), 4 enthesitis-related arthritis (ERA) HLA B27+, and 2 psoriatic arthritis were included in a retrospective evaluation. Mean disease onset age was 6.5 yrs (range 1-16), mean disease duration 12.7 yrs (range 0.2-46.2).
We analyzed the correlation between TMJ involvement with the following items: ILAR categories, age at onset, gender, pattern of articular involvement (large joints, small ones, hips, cervical spine).
Results 88/230 patients (38.3%), 36.8% of females and 41% of males showed a clinical TMJ involvement. Mean age at onset (or diagnosis) of TMJ involvement was 8.3 yrs. 62/88 pts (70.5%) had a bilateral clinical signs of condylar alteration.
The involvement of TMJ was observed in 38.3% of the whole population (54.5% of oligoarthritis, 27.3% polyarthritis RF negative, 2.3% polyarthritis RF positive, 9.1% soJIA, 4.5% ERA and 2.3% juvenile psoriatic arthritis)
3 cases (2 females and 1 male) presented with an involvement of TMJ at the diagnosis of JIA.
The rate of TMJ involvement was higher in the pts with an early onset of the disease (52.3% in the 0-6 yrs group, vs 36.4% in 7-12 yrs group and 11.3% in 13-16 yrs group).
In 56/88 pts (63.3%) TMJ disease was associated with an involvement of large joints, in 4/88 (4.54%) with small joints, in 24/88 (27.7%) with hips and in 18/88 (20.45%) with cervical spine.
Conclusions An early onset of JIA, the oligoarticular ILAR category and a pattern of large joints involvement seem correlated with a higher rate of TMJ disease. Predictive factors of TMJ involvement should be confirmed in a larger JIA population and may be useful for clinicians to adopt appropriate prevention strategies of TMJ disease.
Disclosure of Interest None declared