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Table 2 Outcome of studies evaluating local therapy for TMJ arthritis

From: Temporomandibular joint arthritis in juvenile idiopathic arthritis, now what?

Study Subjective change Physical exam change Imaging change Safety
Arabshahi et al. [122] Resolution of pain in 10/13 subjects MIO increase of 4.8 mm Improved active findings on MRI in > 67% of TMJs (14 subjects) Transient Cushing syndrome in 2 subjects
Ringold et al. [106] Decreased incidence of one or more TMJ symptoms (60% to 28%) MIO increase of 6.6 mm; decreased incidence of jaw deviation (40% to 16%) CT: worsening changes in 10, no change in 3, and improvement in 2 subjects Subcutaneous atrophy in 1 subject, IA calcification in two subjects
Weiss et al. [14] ND Improved MIO in 9/16 abnormal at baseline Decreased MRI findings of active arthritis in 5/6 ND
Parra et al. [123]1 “Good” response in 80/99 encounters,
“Partial” response in 10, and “Poor”
response in 9
ND ND Skin atrophy in 1 subject
Mino et al. [67] Resolution of pain in 11/15 (73%) with pain at baseline Improved MIO of 5 mm among the 18 patients with decreased MIO at baseline ND Transient painless erythema in 24/28 (86%); metallic taste in one subject
Habibi et al. [124] Improved pain in 17/17 subjects and improved chewing dysfunction in 5/7 subjects Improved jaw deviation in 13/14 subjects ND Scar in one subject
Stoll et al. [125] ND Increased MIO by 2.7 mm Of 62 TMJs: 24 improved, 30 stable, 8 worse One subject each with localized swelling, fever x two weeks, and hypopigmentation
Stoll et al. [56] ND No change in MIO No improvement overall by MRI; resolution of inflammation in six TMJs No AEs
Olsen-Bergem et al. [64] Improved pain at rest and with palpation Increased lateral excursion of 3.7 mm (Triamcinolone group) ND ND
Olsen-Bergem et al. [64] Improved pain at rest and with palpation Increased lateral excursion of 4.6 mm (arthrocentesis alone group) ND ND
Lochbuhler et al. [52]2 ND ND Improved inflammatory grade of MRI Decreased growth of mandibular ramus
Stoll et al. [55] ND No change in MIO Worsening of active and chronic MRI findings ND
Stoustrup et al. [126] Improved short-term pain frequency and intensity No significant changes in MIO, laterotrusion, or protrusion ND ND
Kinard et al. [65] Decreased pain Improved MIO ND Transient subcutaneous atrophy
Resnick et al. [127] Decreased pain Improved MIO of 5.8 mm Decreased ER of 1.06 ND
Resnick et al. [128] Resolution of pain in 34/37 (92%) Improved MIO of 5.0 mm (anatomic) or 5.1 mm (image) Decreased ER of 1.16 (anatomic) or 0.96 (image) ND
Antonarakis et al. [66] TA: Decreased VAS 2.6
L: Decreased VAS 1
TA: Improved MIO of 2.3 mm
L: Improved MIO of 1.4 mm
TA: Improved in 18 / 42 TMJs
L: Improved in 5/16
  1. 1Some of the reports reflect children who had more than one round of injections. 2Intra-articular placement was evaluated with MRI. Those with IA placement demonstrated more robust improvement but more impairment of mandibular growth. Abbreviations: ER enhancement ratio, L lavage alone, MIO maximal incisal opening, ND not documented, TA triamcinolone acetonide, TMJ temporomandibular joint