Table 2 Summary of series describing the outcomes of intra-articular corticosteroid injections of the temporomandibular joint (TMJ) in JIA
Series | No. of patients/No. of injections | Diagnostic Imaging Modality | Duration of Follow-up | Selected Outcomes | Adverse Events | Intra-articular injections |
|---|---|---|---|---|---|---|
[41] | 21/36 | MRI with gadolinium | Follow-up clinical assessment: Median: 42 days Range: 1–164 days Follow-up imaging: Mean: 52 days Range: 21–125 | 1. Pain resolved in 5 patients. 2. Tenderness resolved in 7 of 11 patients. 3. Mean MIO increase of 1.8 mm (p = 0.16 compared to controls) 4. MRI improvement in 23 of 36 joints. 5. Synovial enhancement resolved in 6 of 36 joints. | NA | Injections with triamcinolone hexacetonide. |
[43] | 25/74 | CT | Mean: 26 mos Range: 5–52 mos | 1. 21 of 25 patients asymptomatic at end of study period (10 of 25 normal prior to injection). 2. 18 of 25 patients with normal TMJ exam at end of study period (10 of 25 normal prior to injection). 3. Mean MIO increase of 6.6 mm after first injection. 4. Mean MIO increase of 0.4 mm after subsequent injections | 1 patient with subcutaneous atrophy at injection site (after 5 injections) 2 patients with asymptomatic calcifications | Injections with triamcinolone acetonide or triamcinolone hexacetonide. Performed without radiographic guidance. |
[42] | 10/16 | MRI with gadolinium | 3 mos | 1. Synovial enhancement resolved in 16 of 16 joints. 2. Improvement in asymmetric mouth opening in 3 of 4 patients. | None | Injections with triamcinolone acetonide. |
[40] | 23/40 | MRI with gadolinium | 6–12 mos | 1. Pain resolved in 10 of 13 patients. 2. Mean MIO increase of 5 mm. 3. Resolution of effusion in 11 of 23 joints. | 2 patients with short-term facial swelling | Injections with triamcinolone acetonide or triamcinolone hexacetonide. Performed with CT guidance. |