Temporomandibular joint (TMJ) involvement is an often underrecognized complication of juvenile idiopathic arthritis (JIA) that can cause decreased mandibular growth, altered facial morphology, and orofacial pain. It is estimated that the TMJ is affected in 30–45% of children with JIA. Standardized physical examination and imaging evaluations are important in accurately assessing active TMJ arthritis and sequalae. Little is known about the rate at which providers evaluate TMJ involvement in their clinical practice. Data were obtained from the Childhood Arthritis and Rheumatology Research Alliance (CARRA) Registry. Data fields related to assessment for TMJ arthritis were added in 2019. Patients were included in the study if they had a diagnosis of JIA and had data recorded between January 2020 and August 2021. Standard descriptive statistics were used to describe demographic and clinical features. A total of 17,761 visits were reviewed for a total of 7473 patients with JIA. A total of 52.7% of patients had maximal mouth opening (MMO) recorded as finger breadths or total incisal distance (TID). Only 8% had TID measured. A total of 5.0% had MRI with contrast performed. A total of 939 patients had a diagnosis of TMJ arthritis. Of these, 28.5% had an MRI documented, 83% had an MMO documented, and 40% had TID measured. Few patient-level characteristics were statistically related to having MMO assessed. MRI was more likely to be obtained in older and in female patients. MMO was recorded at a given visit > 80% of the time at 17 sites, and it was recorded < 1% of the time at 8 sites. MRIs were infrequently performed at all sites, with 27 sites having no MRIs obtained and only 7 sites having an MRI obtained at > 10% of visits. MMO is not consistently measured in patients with JIA, and it is rarely measured quantitatively. Similarly, TMJ MRIs are rarely obtained in patients with JIA. Site of care is more associated with TMJ assessments than patient-level characteristics. These data suggest that provider education is needed to improve the assessment of the TMJ in patients with JIA to enable earlier recognition and prevent long-term complications.

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幼年特发性关节炎颞下颌关节的提供者评估：来自 CARRA 数据库的回顾性分析

颞下颌关节 (TMJ) 受累是幼年特发性关节炎 (JIA) 的一种经常被忽视的并发症，可导致下颌生长减慢、面部形态改变和口面部疼痛。据估计，30-45% 的幼年特发性关节炎儿童颞下颌关节受到影响。标准化体检和影像学评估对于准确评估活动性颞下颌关节关节炎和后遗症非常重要。对于医疗服务提供者在临床实践中评估颞下颌关节参与情况的比率知之甚少。数据来自儿童关节炎和风湿病研究联盟 (CARRA) 登记处。 2019 年添加了与 TMJ 关节炎评估相关的数据字段。如果患者被诊断为 JIA，并且在 2020 年 1 月至 2021 年 8 月期间记录了数据，则患者将被纳入研究。使用标准描述性统计数据来描述人口统计和临床特征。总共对 17,761 次就诊进行了审查，共涉及 7473 名 JIA 患者。总共 52.7% 的患者有最大张口度 (MMO)，记录为手指宽度或总切牙距离 (TID)。只有 8% 测量了 TID。总共 5.0% 的人进行了 MRI 对比检查。共有 939 名患者被诊断为颞下颌关节炎。其中，28.5% 的人记录了 MRI，83% 的人记录了 MMO，40% 的人测量了 TID。很少有患者层面的特征与 MMO 评估有统计相关性。 MRI 更有可能在老年患者和女性患者中进行。在 17 个地点，MMO 在一次给定访问中的记录时间超过 80%，在 8 个地点，记录的记录时间少于 1%。所有站点均很少进行 MRI，其中 27 个站点未获得 MRI，只有 7 个站点在 > 10% 的访问中获得了 MRI。 JIA 患者的 MMO 测量结果不一致，而且很少进行定量测量。同样，JIA 患者很少获得 TMJ MRI。护理地点与 TMJ 评估的相关性高于患者水平特征。这些数据表明，需要提供者教育来改善 JIA 患者的 TMJ 评估，以便及早识别并预防长期并发症。