Abstract:
Our study aimed to evaluate the clinical and laboratory features of juvenile idiopathic arthritis (JIA) children with temporomandibular joint (TMJ) arthritis. In the retrospective cohort study, we analyzed data of 753 patients with JIA aged 2-17 years, depending on TMJ arthritis or not. TMJ arthritis can to be diagnosed in the presence of at least two of the following clinical signs of inflammation: pain in TMJ, jaw opening limitation, jaw opening deviation, and micrognathia. We compared clinical, laboratory, and treatment features in JIA patients depending on the involvement of TMJ. TMJ arthritis was detected in 43 (5.7%) of our patients and associated with a longer course of the disease, polyarticular JIA category, treatment with systemic corticosteroids, and longer achievement of the remission and involvement of cervical spine, hip, and shoulder. Active joints >8 (OR = 14.9, p = 0.0000001), delayed remission >7 years (OR = 3.1; p = 0.0004), delayed hip involvement (OR = 4.6; p = 0.041), hip osteoarthritis (OR = 4.0; p = 0.014), cervical spine arthritis (OR = 10.3, p = 0.000001), and corticosteroid treatment (OR = 2.3, p = 0.0007) were associated with TMJ involvement. Patients with TMJ arthritis require more biologics (OR = 3.2, p = 0.0006, HR = 2.4, p = 0.005) and have decreased probability of remission achievement (p = 0.014). Consequently, TMJ arthritis was associated with a severe disease course. Early biologic treatment and corticosteroid avoidance might decrease TMJ involvement.
摘要:
我们的研究旨在评估患有颞下颌关节(TMJ)关节炎的幼年特发性关节炎(JIA)儿童的临床和实验室特征。在回顾性队列研究中,我们分析了753名2-17岁JIA患者的数据,取决于颞下颌关节炎与否。在存在以下至少两种临床炎症体征的情况下,可以诊断出TMJ关节炎:TMJ疼痛,钳口开口限制,钳口开度偏差,和小颌畸形。我们比较了临床,实验室,JIA患者的治疗特征取决于TMJ的受累情况。我们的患者中有43例(5.7%)检测到TMJ关节炎,并且与病程较长有关,多关节JIA类,全身性皮质类固醇治疗,延长颈椎的缓解和受累时间,臀部,和肩膀。活动接头>8(OR=14.9,p=0.0000001),延迟缓解>7年(OR=3.1;p=0.0004),延迟髋关节受累(OR=4.6;p=0.041),髋关节骨关节炎(OR=4.0;p=0.014),颈椎关节炎(OR=10.3,p=0.000001),皮质类固醇治疗(OR=2.3,p=0.0007)与TMJ受累相关.患有TMJ关节炎的患者需要更多的生物制剂(OR=3.2,p=0.0006,HR=2.4,p=0.005),并且获得缓解的可能性降低(p=0.014)。因此,TMJ关节炎与严重的病程有关。早期生物治疗和避免皮质类固醇可能会减少TMJ的受累。