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      Safety and efficacy of ultrasound guided corticosteroid injections into temporomandibular joints in children with active juvenile idiopathic arthritis

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      Pediatric Rheumatology Online Journal
      BioMed Central
      18th Pediatric Rheumatology European Society (PReS) Congress
      14-18 September 2011

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          Abstract

          Background Prevalence of temporomandibular arthritis in JIA varies widely, reported rates ranging from 17- 87%. Untreated inflammation with joint destruction can lead to asymmetrical mandibular growth with jaw deviation, dental malocclusion and micrognathia. Intra-articular steroid injection for TMJ arthritis has been found to be effective. There are limited reports on the efficacy of ultrasound guided steroid injections of the TMJ’s in JIA. Aim To assess the safety and efficacy of ultrasound guided corticosteroid injection, done by a paediatric rheumatologist, into the temporomandibular joints in children with JIA. Methods Children with JIA presenting to rheumatology clinic assessed for TMJ arthritis. Triamcinolone hexacetonide injected in those with active arthritis assessed by MRI, using ultrasound guidance under general anaesthesia by a single paediatric rheumatologist trained in procedure. Efficacy and safety was assessed post-injection by patient guided symptoms and physical examination. Results 38 children (34 girls) with TMJ injection between Jan 2009–Jan 2011 studied. Mean age: 12.25±3.55years(range=5-18 years). Mean disease duration: 4.54±2.73 years (1.5-11.1years). Symptoms pre-injection: pain:17/38(44.7%), jaw deviation:14/38(36.8%), restricted jaw movement:13/38(34.2%), chewing dysfunction:7/38(18.4%), micrognathia:5(12.5%). Total 63 joints injected. Injection efficacious:58/63(92.06%) joints(Table 1). Stiffness was persistent in 2 children with both TMJ’s injected & 1 had persistent jaw deviation. Injection site scar in 1 child. Table 1 Improvement in symptoms Symptom Improvement [n (%)] Pain (17) 17 (100%) Jaw deviation (14) 13 (92.8%) Chewing dysfunction(7) 5 (71.4%) Conclusions Ultrasound guided corticosteroid injection into the temporomandibular joint done by a paediatric rheumatologist trained in the procedure safe with a high rate of success.

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          Author and article information

          Conference
          Pediatr Rheumatol Online J
          Pediatric Rheumatology Online Journal
          BioMed Central
          1546-0096
          2011
          14 September 2011
          : 9
          : Suppl 1
          : O27
          Article
          1546-0096-9-S1-O27
          10.1186/1546-0096-9-S1-O27
          3194422
          6866921b-81a7-47a6-8875-cd5951982c03
          Copyright ©2011 Habibi et al; licensee BioMed Central Ltd.

          This is an open access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

          18th Pediatric Rheumatology European Society (PReS) Congress
          Bruges, Belgium
          14-18 September 2011
          History
          Categories
          Oral Presentation

          Pediatrics
          Pediatrics

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