Early diagnosis of temporomandibular joint arthritis in children with juvenile idiopathic arthritis. A systematic review

Aim Asymptomatic TMJ arthritis in juvenile idiopathic arthritis (JIA) patients may cause damage and deformity of the joint. The clinical manifestation of early-stage TMJ arthritis is not characteristic. Clinical findings commonly appear in a late stage of TMJ involvement, but they can also be masked by antirheumatic therapy. The absence of clinical symptoms, and the lack or insufficient clinical signs do not provide reliable information about the TMJ involvement. The aim of the study was to conduct a systematic review of the evidence for clinical symptoms and signs of early-stage TMJ arthritis, as well as for correlation between clinical parameters and TMJ abnormalities imaging in JIA patients. Methods Study design: A systematic review of papers published from 1998 to 2019 regarding early clinical and imaging findings of TMJ arthritis in JIA patients. Results The search resulted in 292 studies. Eleven publications were included in the review. Conclusions Clinical signs and symptoms do not allow to detect the early stage of TMJ arthritis in JIA patients. To monitor individual orofacial development, periodic TMJ clinical examination should be a part of an evaluation of JIA children's growth. There is a need to develop clinical management guidelines, as well as diagnosis standards of clinical and imaging TMJ examination for JIA children, considering their developmental age.