Maxillary sinusitis prevalence in juvenile arthritis: cone beam CT study

Background: To evaluate a possible correlation between Juvenile Idiopathic Arthritis (JIA) and sinusitis of the maxillary sinuses and determine their prevalence. Methods: The Juvenile Idiopathic Arthritis is a chronic inflammatory disorder of probable autoimmune origin. The most important manifestation of this disease is chronic synovitis, synovial fluid pressure is produced in it often causes pain. The JIA begins before the age of 16 years of age. Sinusitis of the maxillary sinus is an inflammatory process, acute or chronic, causing a marked thickening of the mucosa, with or without local pain. This study analyzed 200 Cone Beam Computed Tomography (CBCT). Of these 100 patients suffering from JIA, 100 were healthy. All patients who fall in this study were aged between 8 and 16 years. CBCT data were captured using an I-CAT Cone Beam 3-D imaging system (Imaging Sciences International, Hatfield, PA, USA) and processed using the I-CAT Vision viewing software (Croall Radiography, San Jose, CA, USA), which allows 3D image visualization and measurement: images are shown as a three-dimensional rendering and in their three spatial projections (frontal, lateral and axial). All CBCT were observed in the three planes of space, bringing attention to the coronal and trans-verse sections. Were not considered pathological maxillary sinuses presenting with mucous cysts and those with mild thickening of the membrane of the maxillary sinus (within 2-3 mm). Were considered acute sinusitis showed that, in the above sections, air-fluid level visible and those that showed complete obstruction (empyema) of the maxillary sinus and the complex osteomeatale. Results: The analysis of CT slices showed involvement of the maxillary sinuses in greater proportion in patients with JIA (24%), whereas in healthy subjects are involved in only 11% of cases. The difference between the two study groups was statistically significant (p = 0.0156) (X? = 5.85). Of the 24 patients with JIA, 50% showed bilateral sinusitis, 50% unilateral sinusitis. In healthy patients with sinusitis, however, the percentages vary: 36.4% 63.6% unilateral and bilateral sinusitis. Conclusions: Only 1 from 11 healthy patients showing acute sinusitis, the remaining 10 cases had chronic sinusitis. Of the 24 patients with JIA, only 2 have acute sinusitis. In most cases analyzed, therefore, the sinusitis is chronic, especially in patients with JIA. In light of what it is possible to assume a correlation between Juvenile Rheumatoid Arthritis (IRA) and sinusitis.