{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T12:09:11Z","timestamp":1781870951216,"version":"3.54.5"},"reference-count":42,"publisher":"The Journal of Rheumatology","issue":"9","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Rheumatol"],"published-print":{"date-parts":[[2014,9]]},"abstract":"<jats:sec><jats:title>Objective.<\/jats:title><jats:p>Temporomandibular joint (TMJ) arthritis, commonly considered oligoarthritic\/asymptomatic, occurs frequently in children with juvenile idiopathic arthritis (JIA), and gadolinium-enhanced magnetic resonance imaging (Gd-MRI) has proved to be a sensitive diagnostic tool in this context. We compared the reliability of clinical examinations to Gd-MRI results in diagnosing the condition.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods.<\/jats:title><jats:p>Patients with JIA (134 consecutive) underwent routine clinical and Gd-MRI examinations. The clinical items examined were clicking, tenderness (TMJ\/adjacent muscles), and mouth-opening capacity. Blinded MRI reading focused on inflammation (synovitis\/hypertrophy). After statistical power analysis, the clinical findings for 134 healthy controls were included. Contingency analysis was used to determine the sensitivity, specificity, and frequency of clinical symptoms (JIA\/healthy controls); Cohen\u2019s \u03ba was used to establish the interrater reliability.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results.<\/jats:title><jats:p>Statistically significant differences were observed between JIA and healthy control groups with regard to the concise screening items (power analysis &gt; 0.95), whereas no differences in mouth-opening capacity were noted. In 80% of the patients with JIA, Gd-MRI revealed signs of TMJ arthritis, with positive correlations between concise screening items and Gd-MRI results. The average specificity was 0.81, but the sensitivity was low, at 0.42. Combining items led to a marked increase in the sensitivity (0.73). There was a high rate of both false-negative and false-positive results (corresponding to clinical underdiagnosis or overdiagnosis of TMJ arthritis).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion.<\/jats:title><jats:p>Despite a relatively high specificity, clinical examination alone does not seem sufficiently sensitive to adequately detect TMJ arthritis. Thus, a relatively high number of cases will be missed or overdiagnosed, potentially leading to undertreatment or overtreatment. Gd-MRI may support correct diagnosis, thereby helping to prevent undertreatment or overtreatment.<\/jats:p><\/jats:sec>","DOI":"10.3899\/jrheum.131337","type":"journal-article","created":{"date-parts":[[2014,7,2]],"date-time":"2014-07-02T10:12:25Z","timestamp":1404295945000},"page":"1871-1877","source":"Crossref","is-referenced-by-count":69,"title":["Reliability of Clinical Symptoms in Diagnosing Temporomandibular Joint Arthritis in Juvenile Idiopathic Arthritis"],"prefix":"10.3899","volume":"41","author":[{"given":"Bernd","family":"Koos","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marinka","family":"Twilt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ullrike","family":"Kyank","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helge","family":"Fischer-Brandies","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Volker","family":"Gassling","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikolay","family":"Tzaribachev","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2262","published-online":{"date-parts":[[2014,7,1]]},"reference":[{"key":"2018112909332331000_41.9.1871.1","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1177\/095952879708000106","article-title":"On a form of chronic joint disease in children","volume":"80","author":"Still","year":"1897","journal-title":"Med Chir Trans"},{"key":"2018112909332331000_41.9.1871.2","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kep068"},{"key":"2018112909332331000_41.9.1871.3","doi-asserted-by":"publisher","DOI":"10.1002\/art.23401"},{"key":"2018112909332331000_41.9.1871.4","doi-asserted-by":"publisher","DOI":"10.3758\/BRM.41.4.1149"},{"key":"2018112909332331000_41.9.1871.5","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.10091810"},{"key":"2018112909332331000_41.9.1871.6","first-page":"329","article-title":"Micrognathia, temporomandibular joint changes and dental occlusion in juvenile rheumatoid arthritis of adolescents and adults","volume":"89","author":"Larheim","year":"1981","journal-title":"Scand J Dent Res"},{"key":"2018112909332331000_41.9.1871.7","doi-asserted-by":"crossref","first-page":"5","DOI":"10.3109\/03009748209098105","article-title":"The temporomandibular joint in juvenile rheumatoid arthritis. 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