BACKGROUND: Juvenile idiopathic arthritis (JIA) has an incidence that ranges from 1 to 22 per 100,000 children worldwide, with involvement of the temporomandibular joint (TMJ) in 17-87% of patients. Intraarticular corticosteroid injections are beneficial in the local treatment of JIA and of other types of arthritis. OBJECTIVE: To describe and assess the accuracy of an US-guided technique for visualization of needle placement within the TMJ in children. MATERIALS AND METHODS: Between January 2000 and November 2007, 180 TMJ injections were performed during 116 encounters in 83 children with arthritis (71 girls, 12 boys; mean age 12.0 years). Access was obtained under sterile conditions using US guidance (linear 15-MHz or curvilinear 8-MHz transducers) in a coronal plane, and confirmed with CT. To minimize radiation, a limited focused CT protocol was developed. RESULTS: A bilateral injection was performed in 65 encounters (57%). Twenty-three children had repeat TMJ injections. All injections were performed using US guidance. CT confirmation was used in 127/180 TMJs (70%). In those confirmed with CT, the needle tip was intra-articular in 91% of cases. Triamcinolone hexacetonide was used in 92% of injections and triamcinolone acetonide in 8%. One major complication was encountered (skin atrophy at the injection site). CONCLUSION: In our experience, TMJ injections using sonographic guidance is a safe, effective and accurate procedure.
BACKGROUND:Juvenile idiopathic arthritis (JIA) has an incidence that ranges from 1 to 22 per 100,000 children worldwide, with involvement of the temporomandibular joint (TMJ) in 17-87% of patients. Intraarticular corticosteroid injections are beneficial in the local treatment of JIA and of other types of arthritis. OBJECTIVE: To describe and assess the accuracy of an US-guided technique for visualization of needle placement within the TMJ in children. MATERIALS AND METHODS: Between January 2000 and November 2007, 180 TMJ injections were performed during 116 encounters in 83 children with arthritis (71 girls, 12 boys; mean age 12.0 years). Access was obtained under sterile conditions using US guidance (linear 15-MHz or curvilinear 8-MHz transducers) in a coronal plane, and confirmed with CT. To minimize radiation, a limited focused CT protocol was developed. RESULTS: A bilateral injection was performed in 65 encounters (57%). Twenty-three children had repeat TMJ injections. All injections were performed using US guidance. CT confirmation was used in 127/180 TMJs (70%). In those confirmed with CT, the needle tip was intra-articular in 91% of cases. Triamcinolone hexacetonide was used in 92% of injections and triamcinolone acetonide in 8%. One major complication was encountered (skin atrophy at the injection site). CONCLUSION: In our experience, TMJ injections using sonographic guidance is a safe, effective and accurate procedure.
Authors: K Raza; C Y Lee; D Pilling; S Heaton; R D Situnayake; D M Carruthers; C D Buckley; C Gordon; M Salmon Journal: Rheumatology (Oxford) Date: 2003-04-16 Impact factor: 7.580
Authors: Bita Arabshahi; Esi Morgan Dewitt; Ann Marie Cahill; Robin D Kaye; Kevin M Baskin; Richard B Towbin; Randy Q Cron Journal: Arthritis Rheum Date: 2005-11
Authors: Andrea T Borchers; Carlo Selmi; Gurtej Cheema; Carl L Keen; Yehuda Shoenfeld; M Eric Gershwin Journal: Autoimmun Rev Date: 2005-10-27 Impact factor: 9.754
Authors: Paula Frid; Thomas A Augdal; Tore A Larheim; Josefine Halbig; Veronika Rypdal; Nils Thomas Songstad; Annika Rosén; Karin B Tylleskär; Johanna Rykke Berstad; Berit Flatø; Peter Stoustrup; Karen Rosendahl; Eva Kirkhus; Ellen Nordal Journal: Pediatr Rheumatol Online J Date: 2020-10-01 Impact factor: 3.054