Evaluation of temporomandibular joint involvement in juvenile idiopathic arthritis patients.

Juvenile idiopathic arthritis (JIA) is a common, chronic and inflammatory rheumatological disease of childhood. The disease can affect all synovial joints in the body. Temporomandibular joints (TMJs) are important areas of involvement in JIA, which are frequently involved but often not noticed because the involvement is usually asymptomatic. The aim of this study is to determine the frequency and risk factors of TMJ joint involvement in juvenile idiopathic arthritis patients admitted to our clinic, and to guide for early diagnosis and treatment. Patients who applied to this study with the diagnosis of JIA between January 2014 and May 2017 at Pediatric Rheumatology Clinic, were followed up regularly in our clinic, had a accessible medical history, and a rheumatology polyclinic record. Patients with contrast-enhanced TMJ Magnetic Resonance Imaging (MRI) taken and reported by the radiologist were included. TMJ involvement was detected in 51.2% of the 41 patients included in the study. It was found that 71.5% of the patients with TMJ involvement were asymptomatic and 71.5% of the patients had chronic involvement. When the patients with and without TMJ involvement were compared according to the contrast-enhanced TMJ MRI results; In the patient group with involvement, the polyarticular onset subtype was seen at a higher rate (p = 0.005), the age of onset was earlier (p = 0.003), the disease duration was longer (p = 0.037), more joints were involved (p = 0.005), the ESR values ​​were higher (p = 0.0001), and the treatment compliance and treatment responses of the patients in this group were worse (p = 0.001, p = 0.0001). TMJ involvement is common in JIA patients and can occur at any stage of the disease. It is often asymptomatic and progresses insidiously, leading to chronic and degenerative changes in the mandible at an early stage. Due to its asymptomatic nature, the insidious progression, and the risk of causing chronic, irreversible sequelae, it is crucial to screen high-risk JIA patients regularly with contrast-enhanced TMJ MRI, which remains the gold standard method. While specific risk factors are difficult to pinpoint, some factors may increase the likelihood of TMJ involvement. To better identify these high-risk patients and determine which individuals require regular screening, larger-scale and multicenter studies are essential.

Sefer AP ，Erguven M 《Pediatric Rheumatology》

Erratum: Eyestalk Ablation to Increase Ovarian Maturation in Mud Crabs.

《Jove-Journal of Visualized Experiments》

Defining the optimum strategy for identifying adults and children with coeliac disease: systematic review and economic modelling.

Elwenspoek MM ，Thom H ，Sheppard AL ，Keeney E ，O'Donnell R ，Jackson J ，Roadevin C ，Dawson S ，Lane D ，Stubbs J ，Everitt H ，Watson JC ，Hay AD ，Gillett P ，Robins G ，Jones HE ，Mallett S ，Whiting PF ... -  《-》

Histopathology of Idiopathic Condylar Resorption Differs From Temporomandibular Joint-Only Juvenile Idiopathic Arthritis.

Idiopathic condylar resorption (ICR) is a rare condition of unknown etiology characterized by progressive decrease in volume and pathologic remodeling of a previously normal mandibular condyle. Juvenile idiopathic arthritis (JIA) affecting only the temporomandibular joint (TMJ-only JIA) is characterized by synovitis and destruction of TMJ tissues without involvement of other joints. It is often difficult to differentiate the 2 conditions because they exhibit similar phenotypes. To compare histology of resected condylar specimens from patients with ICR and TMJ-only JIA. Specific aims were as follows: 1) to correlate longitudinal clinical data with histopathology of resected condyle specimens and 2) to compare resorption patterns between the 2 disease processes. This was a retrospective cohort study of patients treated at the Massachusetts General Hospital from 1999 through 2023. Primary predictor variable was the diagnosis (ICR or JIA). Secondary predictor variables included age, gender, race, putative contributing factors, and laboratory studies. Primary outcome variable was presence or absence of inflammatory infiltrates in bone and synovial specimens. Secondary outcome variables were structural integrity and morphologic characteristics of the condylar cartilage and bone. Spearman correlation was used to assess the relationship between histological scores and age, gender, and possible associated contributing factors. A P value < .05 was considered statistically significant. Thirty-five subjects (67 specimens) were included in group 1 (ICR). Eight subjects (15 specimens) were included in group 2 (TMJ-only JIA). The histopathologic findings in ICR consisted of severe and irregular cartilage surface disruption, fibrocartilage degeneration, and subchondral bone with no inflammatory infiltrate. Degeneration was observed to begin at the anterior pole of the condyle and progress eventually to total resorption to the sigmoid notch. TMJ-only JIA was notable for more severe condylar degeneration and inflammation in the bone and synovia. There was no specific pattern of degeneration. For both groups, the subject's age, gender, or putative contributing factors did not correlate with the histopathologic scores. These results support the hypothesis that ICR and TMJ-only JIA are distinct clinical entities and can be distinguished by histopathologic findings in the mandibular condyles and synovia.

Boos-Lima FBDJ ，Guastaldi FPS ，Nielsen GP ，Kaban LB ，Peacock ZS ... -  《-》

Maximal mouth opening is a simple method to evaluate the treatment outcome of temporomandibular joint arthritis in patients with juvenile idiopathic arthritis.

Huhtanen M ，Mikola K ，Kiukkonen A ，Palotie T ... -  《-》