Temporomandibular Joint Arthritis in Pediatric Sjögren Disease and Sarcoidosis

To the Editor: Arthritis of the temporomandibular joint (TMJ) is a well recognized entity in patients with juvenile idiopathic arthritis (JIA). It is usually painless and even minor radiographic changes of the TMJ have been associated with disruption in mandibular growth and a number of other craniofacial changes1. Recently, magnetic resonance imaging (MRI) evaluations have proven to have much greater sensitivity to detect arthritis compared to ultrasound, and placed the prevalence of TMJ arthritis in this population between 63% and 75%2,3. Due to this high prevalence, patients with JIA frequently receive contrast-enhanced MRI scans of the TMJ as a standard evaluation for arthritis in several clinical centers. There are other rheumatologic diseases that can also present with TMJ inflammation [e.g., sarcoidosis, Sjogren disease, mixed connective tissue disease (MCTD)]4,5,6, but the prevalence is less known. During the course of clinical care at the Pediatric Rheumatology Clinic at Children’s Hospital of Alabama (Birmingham, AL, USA), several non-JIA arthritis patients have presented with … Address correspondence to Dr. Cron; E-mail: rcron{at}peds.uab.edu