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Erschienen in: Pediatric Radiology 9/2010

01.09.2010 | Original Article

Use and accuracy of US guidance for image-guided injections of the temporomandibular joints in children with arthritis

verfasst von: Dimitri A. Parra, Melissa Chan, Ganesh Krishnamurthy, Lynn Spiegel, Joao G. Amaral, Michael J. Temple, Philip R. John, Bairbre L. Connolly

Erschienen in: Pediatric Radiology | Ausgabe 9/2010

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Abstract

Background

Juvenile idiopathic arthritis (JIA) has an incidence that ranges from 1 to 22 per 100,000 children worldwide, with involvement of the temporomandibular joint (TMJ) in 17–87% of patients. Intraarticular corticosteroid injections are beneficial in the local treatment of JIA and of other types of arthritis.

Objective

To describe and assess the accuracy of an US-guided technique for visualization of needle placement within the TMJ in children.

Materials and methods

Between January 2000 and November 2007, 180 TMJ injections were performed during 116 encounters in 83 children with arthritis (71 girls, 12 boys; mean age 12.0 years). Access was obtained under sterile conditions using US guidance (linear 15-MHz or curvilinear 8-MHz transducers) in a coronal plane, and confirmed with CT. To minimize radiation, a limited focused CT protocol was developed.

Results

A bilateral injection was performed in 65 encounters (57%). Twenty-three children had repeat TMJ injections. All injections were performed using US guidance. CT confirmation was used in 127/180 TMJs (70%). In those confirmed with CT, the needle tip was intra-articular in 91% of cases. Triamcinolone hexacetonide was used in 92% of injections and triamcinolone acetonide in 8%. One major complication was encountered (skin atrophy at the injection site).

Conclusion

In our experience, TMJ injections using sonographic guidance is a safe, effective and accurate procedure.
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Metadaten
Titel
Use and accuracy of US guidance for image-guided injections of the temporomandibular joints in children with arthritis
verfasst von
Dimitri A. Parra
Melissa Chan
Ganesh Krishnamurthy
Lynn Spiegel
Joao G. Amaral
Michael J. Temple
Philip R. John
Bairbre L. Connolly
Publikationsdatum
01.09.2010
Verlag
Springer-Verlag
Erschienen in
Pediatric Radiology / Ausgabe 9/2010
Print ISSN: 0301-0449
Elektronische ISSN: 1432-1998
DOI
https://doi.org/10.1007/s00247-010-1581-2

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