Radiographic temporomandibular joint abnormalities in patients with juvenile chronic arthritis during a controlled study of sodium aurothiomalate and D-penicillamine.

Sixty-two patients with juvenile chronic arthritis (JCA) were randomized to 50-week treatment with either sodium aurothiomalate (G) or D-penicillamine (PEN) and followed with regard to radiographic changes of the temporomandibular joints (TMJ). The radiographic methods comprised panoramic radiography and oblique lateral transcranial radiography, occasionally supplemented with other methods. The radiographs were read by a single assessor who did not know the type of drug treatment. Radiographic progression was seen in one G-treated and six PEN-treated patients with polyarticular JCA, and in one G-treated patient with pauci-articular JCA. A relation between changes in radiographic TMJ findings and disease activity was demonstrated. Radiographic examination of the TMJ seems to be of value in therapeutic trials in patients with JCA.