A cohort study of patients with juvenile idiopathic arthritis and arthritis of the temporomandibular joint: outcome of arthrocentesis with and without the use of steroids

• Published in: International journal of oral and maxillofacial surgery Vol. 43; no. 8; pp. 990 - 995
• Main Authors: Olsen-Bergem, H, Bjørnland, T
• Format: Journal Article
• Language: English
• Published: Denmark Elsevier Ltd 01.08.2014
• Subjects: arthritis; Arthritis, Juvenile - therapy; arthrocentesis; Child; Dentistry; Female; Humans; Injections, Intra-Articular; intra-articular injections; JIA; Male; Osteoarthritis - therapy; Pain Measurement; Paracentesis - methods; steroids; Steroids - administration & dosage; Steroids - therapeutic use; Surgery; Temporomandibular Joint Disorders - therapy; TMJ; Treatment Outcome; Triamcinolone Acetonide - administration & dosage; Triamcinolone Acetonide - analogs & derivatives; Triamcinolone Acetonide - therapeutic use; Ultrasonography, Interventional; TMJ; arthrocentesis; intra-articular injections; steroids; JIA; arthritis
• ISSN: 0901-5027; 1399-0020
• DOI: 10.1016/j.ijom.2014.03.018

Abstract The purpose of this study was to evaluate the effects of intra-articular temporomandibular joint (TMJ) treatment in patients with juvenile idiopathic arthritis (JIA). The inclusion criteria were met by 21 patients (38 joints). Joints were randomly selected for either arthrocentesis alone ( n = 17) or arthrocentesis with the additional use of triamcinolone hexacetonide ( n = 21) using a closed single-needle system. Measurements of pain and function were performed at baseline and at follow-up after 3 and 8 months. Pain on opening and lateral excursion improved significantly after injections. Pain decreased significantly from baseline to first and second control on a visual analogue scale (VAS) for overall pain (49–18–8) and overall function (41–19–4). Significant improvement was recorded for pain on palpation of muscles and joints. There was no statistically significant difference between the treatment modalities, with or without glucocorticoid injection. Arthrocentesis in the TMJ treatment of patients with JIA may be beneficial and steroids had no additional effect. Further studies are needed to evaluate the long-term effects on the TMJ structures and on condylar growth from arthrocentesis and intra-articular steroid injections.