Magnetic Resonance Imaging Findings following Intraarticular Infliximab Therapy for Refractory Temporomandibular Joint Arthritis among Children with Juvenile Idiopathic Arthritis

Matthew Laurence Stoll; Yoginder Nath Vaid; Saurabh Guleria; Timothy Beukelman; Peter Daniel Waite; Randy Quentin Cron

doi:10.3899/jrheum.150308

Magnetic Resonance Imaging Findings following Intraarticular Infliximab Therapy for Refractory Temporomandibular Joint Arthritis among Children with Juvenile Idiopathic Arthritis

J Rheumatol. 2015 Nov;42(11):2155-9. doi: 10.3899/jrheum.150308. Epub 2015 Sep 1.

Authors

Matthew Laurence Stoll¹, Yoginder Nath Vaid², Saurabh Guleria², Timothy Beukelman², Peter Daniel Waite², Randy Quentin Cron²

Affiliations

¹ Form the Department of Pediatrics, and Department of Oral and Maxillofacial Surgery, University of Alabama at Birmingham; Department of Radiology, Children's of Alabama, Birmingham, Alabama, USA.M.L. Stoll, MD, PhD, MSCS, Department of Pediatrics, University of Alabama at Birmingham; Y.N. Vaid, MD; S. Guleria, MD, Department of Radiology, Children's of Alabama; T. Beukelman, MD, MSCE, Department of Pediatrics, University of Alabama at Birmingham; P.D. Waite, MPH, DDS, MD, Department of Oral and Maxillofacial Surgery, University of Alabama at Birmingham; R.Q. Cron, MD, PhD, Department of Pediatrics, University of Alabama at Birmingham. [email protected].
² Form the Department of Pediatrics, and Department of Oral and Maxillofacial Surgery, University of Alabama at Birmingham; Department of Radiology, Children's of Alabama, Birmingham, Alabama, USA.M.L. Stoll, MD, PhD, MSCS, Department of Pediatrics, University of Alabama at Birmingham; Y.N. Vaid, MD; S. Guleria, MD, Department of Radiology, Children's of Alabama; T. Beukelman, MD, MSCE, Department of Pediatrics, University of Alabama at Birmingham; P.D. Waite, MPH, DDS, MD, Department of Oral and Maxillofacial Surgery, University of Alabama at Birmingham; R.Q. Cron, MD, PhD, Department of Pediatrics, University of Alabama at Birmingham.

PMID: 26329345
DOI: 10.3899/jrheum.150308

Abstract

Objective: To evaluate the involvement of intraarticular (IA) infliximab (IFX) in the management of temporomandibular joint (TMJ) arthritis associated with juvenile idiopathic arthritis (JIA) that is refractory to systemic treatment and IA corticosteroid therapy.

Methods: Ours was a retrospective study of children with JIA who received IA IFX into the TMJ. The effectiveness of treatment on the progression of acute and chronic changes was assessed by a quantitative magnetic resonance imaging scoring system.

Results: Median acute and chronic scores worsened by 0.25 and 0.75, respectively. In multivariate analysis, worsening acute scores and passage of time predicted worsening of the chronic scores.

Conclusion: IA IFX allowed for progression of refractory TMJ arthritis in most but not all children with JIA.

Keywords: INFLIXIMAB; INTRAARTICULAR INJECTIONS; JUVENILE IDIOPATHIC ARTHRITIS; MAGNETIC RESONANCE IMAGING; TEMPOROMANDIBULAR JOINT.

MeSH terms

Adolescent
Analysis of Variance
Arthritis, Juvenile / diagnosis
Arthritis, Juvenile / drug therapy
Arthritis, Juvenile / epidemiology*
Child
Child, Preschool
Cohort Studies
Disease Progression
Female
Follow-Up Studies
Humans
Infliximab / administration & dosage*
Injections, Intra-Articular
Linear Models
Magnetic Resonance Imaging / methods
Male
Multivariate Analysis
Pain Measurement
Recurrence
Retrospective Studies
Risk Assessment
Severity of Illness Index
Temporomandibular Joint Disorders / diagnosis
Temporomandibular Joint Disorders / drug therapy*
Temporomandibular Joint Disorders / epidemiology*
Treatment Outcome
Vereinigte Staaten

Substances

Infliximab