Abstract
Juvenile idiopathic arthritis (JIA) is the most common rheumatic disease in childhood and often involves the temporomandibular joint (TMJ). Herein we present a case of a 9-year-old female patient who sought a rheumatologist with a main complaint of hip pain and was diagnosed with JIA. On that occasion, the TMJ was not evaluated. The disease was controlled with nonsteroidal anti-inflammatory drugs and methotrexate, and the patient was monitored through laboratory tests. Three years after the initial diagnosis, during a dental appointment, facial asymmetry was observed, without painful symptomatology. The clinical examination revealed mandibular retrognathism and malocclusion, with midline deviation to the right. Image studies showed erosion and important flattening of the right condyle. The orthodontic treatment allowed correction of malocclusion, but facial asymmetry persisted. TMJ should always be evaluated in patients with JIA, regardless of the presence of signs or symptoms, because their involvement is frequent and may occur silently.
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