Abstract
BackgroundTemporomandibular joint (TMJ) arthritis is frequently seen in children with chronic arthritis. It has rarely been described in a non-infectious acute setting. We report a case of reactive arthritis isolated to the TMJs and cervical spine.Case presentationA 6-year-old Native American boy hospitalized for treatment of lymphadenitis and aseptic meningitis had an incidental brain magnetic resonance imaging (MRI) finding of effusions in the TMJs, as well as the atlanto-occipital and C1–C2 articulations. Repeat TMJ and cervical spine MRI four weeks later showed resolution of effusions. Reactive TMJ arthritis has been previously reported in adults but not in children.ConclusionThis report represents the first pediatric case of reactive arthritis isolated to the cervical spine and TMJs. Arthritis of the TMJ should be considered in the differential diagnosis of children with reactive arthritides.
Highlights
Temporomandibular joint (TMJ) arthritis is frequently seen in children with chronic arthritis
This report represents the first pediatric case of reactive arthritis isolated to the cervical spine and TMJs
Arthritis of the TMJ should be considered in the differential diagnosis of children with reactive arthritides
Summary
Lumbar puncture revealed an elevated cerebrospinal fluid (CSF) protein of 80 mg/dL, a normal glucose level, red blood cells of 3 per cubic millimeter (mm3), and elevated white blood cells of 29 per mm (21% neutrophils, 52% lymphocytes, 27% monocytes) His CSF and blood cultures were negative and he had normal Ebstein-Barr virus and Bartonella antibody titers. Pediatric Rheumatology 2007, 5:4 http://www.ped-rheum.com/content/5/1/4 marked presence of joint effusions in the temporomandibular joints (TMJ) (Figure 1A), the atlanto-occipital articulation, and the C1–C2 articulations (Figure 2A) He had not complained of posterior neck or TMJ pain, but his parents had noted on the day prior to the MRI, approximately 2 weeks after onset of his symptoms, he seemed to chew his food using a side-to-side, rather than up-anddown jaw motion. Repeat TMJ (Figure 1B) and cervical spine (Figure 2B) MRI 4 weeks later revealed complete resolution of effusions, and his joint examination remained normal
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