Temporomandibular Joint Involvement in Children With Juvenile Idiopathic Arthritis

Purpose:

The purpose of this study is to characterize a population of patients with Juvenile Idiopathic Arthritis (JIA) and temporomandibular joint (TMJ) involvement.

Methods:

We performed a retrospective analysis of patients with JIA evaluated at Children’s Healthcare of Atlanta.from years 2011-2016. Patients were included if they had confirmed JIA and jaw complaints. Medical records were reviewed to document age at first jaw complaints, demographic (age, gender), and arthritis information (JIA subtype, RF status, ANA status, HLA status, involvement of other joints). Descriptive statistics were computed.

Results:

There were 60 patients (52 females) with a mean age of 13 years (range 10 to 16) who met inclusion criteria. The prevalence of JIA subtypes was found to be Poly RF negative (n=19, 31.7%), Oligoarticular persistent (n=15, 25%) Enesthitis related (n=9, 15%), Oligoarticular extended (n=7, 11.7%), Poly RF positive (n=4, 6.7%), Systemic (n=3, 5.0%), Psoriatic (n=2, 3.3%), and Undifferentiated (n=1, 1.7%). Patients were found to be RF positive (n=5, 9.6%), HLA-B27 positive (n=9, 18.4%), and/or ANA positive (n=26, 43.3%). Majority (n=38, 63.3%) did not have involvement of any other joints.

Conclusion:

In our cohort of JIA patients, 12.8% experienced jaw symptoms. Patients that are female, white, with poly RF negative subtype and who are RF negative, HLA-B27 negative, ANA negative, and have involvement of other joints have a higher incidence of jaw symptoms. Children with JIA should have a careful TMJ examination.