The objective of our study is i) to verify the *silent* joint paradigm: to assess the TMJ using MR imaging in children with new onset not yet treated JIA, without clinical signs and symptoms indicating TMJ arthritis; ii) to assess the utility of…
ID
Source
Brief title
Condition
- Autoimmune disorders
Synonym
Research involving
Sponsors and support
Intervention
Outcome measures
Primary outcome
MRI, bite force
Secondary outcome
Physical examination TMJ and Questionnaire
Background summary
Juvenile idiopathic arthritis (JIA) is the most common rheumatic disease in
children. According to the ILAR classification, JIA is diagnosed when the
complaints have been present over six weeks, with an onset before the age of
sixteen. Early detection and management of temporomandibular joint (TMJ)
involvement of JIA prevents the sequels of the disease in the masticatory
system such as pain, reduced mouth opening, dysfunction of joints and muscles,
and growth disturbances leading to facial and mandibular deformities. Screening
by the rheumatologist can detect TMJ involvement but clinical assessments only
such as pain assessment and measuring mandibular range of motion have a high
specificity but low sensitivity. This may have to do with the silent joint
paradigm: children diagnosed with JIA and TMJ arthritis confirmed by MRI, being
the gold standard, may lack clinical signs or symptoms. This hampers early
detection of TMJ arthritis, resulting in treatment delay.
Study objective
The objective of our study is i) to verify the *silent* joint paradigm: to
assess the TMJ using MR imaging in children with new onset not yet treated JIA,
without clinical signs and symptoms indicating TMJ arthritis; ii) to assess the
utility of bite force measurement as predictor for TMJ arthritis.
Study design
cross-sectional study
Study burden and risks
The results of this study are expected to contribute to a better understanding
of detection TMJ involvement in children with new onset JIA as well as in
children in regular treatment. The burden of participation in our study
consists of I) taking the decision to participate in our study, II) one MRI,
III) measurement of the bite force, IV) clinical TMJ examination, V) filling
out one questionnaire, VI) measuring the maximum mouth opening at home and VII)
chewing on a wax tablet (to measure the masticatory performance). The need for
MRI may decrease if bite force turns out to be a valid predictor of TMJ
inflammation.
Heidelberglaan 100
Utrecht 3584CX
NL
Heidelberglaan 100
Utrecht 3584CX
NL
Listed location countries
Age
Inclusion criteria
o Score *0* points on the TMJ screening protocol
o Not yet in regular care for JIA by the rheumatologist (new onset JIA) or diagnosed JIA with an exacerbation and not yet started adequate therapy.
o Age * 6 years; < 16 years of age at JIA diagnosis
o Given oral and written informed consent
Exclusion criteria
o Received previous TMJ treatment
o Undergoing orthodontic treatment
o History of mandibular trauma
o Contra-indication for MRI
o Need for sedation prior to MRI e.g. as a result from claustrophobia
Design
Recruitment
Medical products/devices used
Followed up by the following (possibly more current) registration
No registrations found.
Other (possibly less up-to-date) registrations in this register
No registrations found.
In other registers
| Register | ID |
|---|---|
| CCMO | NL62448.041.17 |