Loading...
Publication
Diagnóstico imagiológico precoce da artrite da articulação temporomandibular em crianças e adolescentes com artrite idiopática juvenil: revisão sistemática
| Name: | Description: | Size: | Format: | |
|---|---|---|---|---|
| 760.84 KB | Adobe PDF |
Authors
Advisor(s)
Abstract(s)
Objetivo: As primeiras alterações provocadas pela artrite idiopática juvenil (AIJ) ocorrem na sinovial, devido a processo inflamatório de grau variável. Os sintomas e o exame clínico da ATM, quando afetada por AIJ, não são bons indicadores do estado da doença, podendo subestimar o grau de inflamação precoce. O objectivo desta revisão sistemática da literatura foi avaliar o valor dos exames imagiológicos no diagnóstico precoce da artrite da ATM em crianças e adolescentes com AIJ, bem como, estabelecer quais os exames imagiológicos mais precisos para o diagnóstico precoce, além dos critérios imagiológicos utilizados para esse fim.
Métodos: Revisão sistemática dos estudos clínicos e caso-controlo publicados de 2010 a 26 de fevereiro de 2021 nas bases de dados Medline, ScienceDirect, Web of Science, Scielo, Academic Search Complete e Supplemental index e que abordaram o diagnóstico precoce da AIJ na ATM de crianças e adolescentes e/ou critérios de diagnóstico precoce utilizando exames imagiológicos.
Resultados: A pesquisa resultou em 375 estudos publicados durante o período determinado. Um total de 38 estudos exigiram a leitura integral e, após a aplicação dos critérios de inclusão e exclusão predefinidos, apenas três estudos foram incluídos.
Conclusões: A RM com contraste à base de gadolinium é à data o gold standard para diagnóstico precoce da AIJ na ATM, sendo o único método atualmente capaz de diferenciar realce e espessamento sinovial com precisão e deve ser realizada, sempre que possível, por rotina clínica no rastreio da doença em pacientes recém-diagnosticados com AIJ e independente da necessidade de realizar sedação.
Objective: The first changes caused by juvenile idiopathic arthritis (JIA) occur in the synovium, due to an inflammatory process of varying degree. Symptoms and clinical examination of the TMJ, when affected by JIA, are not good indicators of the condition of the disease, and may underestimate the degree of early inflammation. The objective of this systematic review of the literature was to evaluate the value of imaging tests in the early diagnosis of TMJ arthritis in children and adolescents with JIA, as well as to establish which imaging tests are more accurate for early diagnosis, in addition to the imaging criteria used for this end. Methods: Systematic review of clinical studies and case-control published from 2010 to February 26, 2021 in the Medline, ScienceDirect, Web of Science, Scielo, Academic Search Complete and Supplemental index databases that addressed the early diagnosis of JIA in TMJ of children and adolescents and/or criteria for early diagnosis using imaging diagnostic exams. Results: The research resulted in 375 studies published during the given period. A total of 38 studies required reading and, after applying the predefined inclusion and exclusion criteria, only three studies were included. Conclusions: Gadolinium-based contrast MRI is the gold standard for early diagnosis of JIA in the TMJ to date, being the only method currently capable of differentiating synovial enhancement and thickening accurately and should be performed, whenever possible, by clinical routine in the screening of the disease in patients newly diagnosed with JIA and regardless of the need to perform sedation.
Objective: The first changes caused by juvenile idiopathic arthritis (JIA) occur in the synovium, due to an inflammatory process of varying degree. Symptoms and clinical examination of the TMJ, when affected by JIA, are not good indicators of the condition of the disease, and may underestimate the degree of early inflammation. The objective of this systematic review of the literature was to evaluate the value of imaging tests in the early diagnosis of TMJ arthritis in children and adolescents with JIA, as well as to establish which imaging tests are more accurate for early diagnosis, in addition to the imaging criteria used for this end. Methods: Systematic review of clinical studies and case-control published from 2010 to February 26, 2021 in the Medline, ScienceDirect, Web of Science, Scielo, Academic Search Complete and Supplemental index databases that addressed the early diagnosis of JIA in TMJ of children and adolescents and/or criteria for early diagnosis using imaging diagnostic exams. Results: The research resulted in 375 studies published during the given period. A total of 38 studies required reading and, after applying the predefined inclusion and exclusion criteria, only three studies were included. Conclusions: Gadolinium-based contrast MRI is the gold standard for early diagnosis of JIA in the TMJ to date, being the only method currently capable of differentiating synovial enhancement and thickening accurately and should be performed, whenever possible, by clinical routine in the screening of the disease in patients newly diagnosed with JIA and regardless of the need to perform sedation.
Description
Keywords
Artrite idiopática juvenil Articulação temporomandibular Diagnóstico precoce Imagem de diagnóstico Criança Juvenile idiophatic arthritis Temporomandibular joint Early diagnosis Diagnostic imaging Child