Artamonov Artem K, Kaneva Maria A, Gordeeva Natalia A, Sorokina Lubov S, Kostik Mikhail M
Hospital Pediatry, Saint-Petersburg State Pediatric Medical University, 194100 Saint-Petersburg, Russia.
Pediatric Rheumatology, Saint-Petersburg Children's Hospital #2, n.a. Saint Mary Magdalene, 199053 Saint-Petersburg, Russia.
Life (Basel). 2023 May 11;13(5):1164. doi: 10.3390/life13051164.
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, = 0.0000001), delayed remission >7 years (OR = 3.1; = 0.0004), delayed hip involvement (OR = 4.6; = 0.041), hip osteoarthritis (OR = 4.0; = 0.014), cervical spine arthritis (OR = 10.3, = 0.000001), and corticosteroid treatment (OR = 2.3, = 0.0007) were associated with TMJ involvement. Patients with TMJ arthritis require more biologics (OR = 3.2, = 0.0006, HR = 2.4, = 0.005) and have decreased probability of remission achievement ( = 0.014). Consequently, TMJ arthritis was associated with a severe disease course. Early biologic treatment and corticosteroid avoidance might decrease TMJ involvement.
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。在这项回顾性队列研究中，我们分析了753例年龄在2至17岁的JIA患者的数据，根据是否患有TMJ关节炎进行分类。TMJ关节炎可在出现以下至少两种炎症临床体征时诊断：TMJ疼痛、张口受限、张口偏斜和小颌畸形。我们比较了根据TMJ受累情况的JIA患者的临床、实验室和治疗特征。我们的患者中有43例（5.7%）检测出TMJ关节炎，其与疾病病程较长、多关节型JIA类别、全身使用糖皮质激素治疗、缓解时间较长以及颈椎、髋关节和肩关节受累有关。活动关节>8个（比值比[OR]=14.9，P=0.0000001）、缓解延迟>7年（OR=3.1；P=0.0004）、髋关节受累延迟（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）和糖皮质激素治疗（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，风险比[HR]=2.4，P=0.005），且缓解的概率降低（P=0.014）。因此，TMJ关节炎与严重的疾病病程相关。早期生物治疗和避免使用糖皮质激素可能会减少TMJ受累。
