Condylar osteophytic neoformation in TMJ arthritis : CBCT vs conventional Rx

Aim: The purpose of this work was to show the role of CBCT versus conventional radiographs for accurate and reliable detection of osteophytic neoformations on mandibular condyle in Juvenile Idiopathic Arthritis (JIA). Materials and Methods: An unusual case report was reported. A 16 years old girl was affected by JIA since 8 year of age. When she was 12 year old, came to our observation severed by rheumatologist and orthodontic treatment was proposed to patient to avoid and prevent the TMJ complications CBCT imaging has been performed and the left condyle demonstrated the bird-beak appearance with a large osteophyte. Osteophyte is the medical term for the overgrowth of bone tissue more commonly called ‘bone spurs’. Despite the term ‘spur’, osteophytes are actually small round lumps of extra bone that grow around joints. Osteophytes are the body’s attempt to compensate for existing bone and ligament degeneration due to age arthritis or injury. Unfortunately, the body’s attempt to heal itself this way is unsuccessful. Results: The CBCT showed mandibular condyle’s morphological and surface changes as cortical erosion, flattening, sclerosis, osteophyte neoformation and a reduced inter-articular space. Discussion: JIA is a common disease of childhood that causes joint inflammation, typically before 16 years of age. When the TMJ is affected, there is often no pain, which delays the diagnosis and treatment. The condylar abnormalities can range from slight erosion and flattining of the articular surfaces to severe destruction of the conyle head or osteophytic neoformations. Osteophytes are formed by the body for the purpose of limiting or stopping motion in a deteriorating joint that becomes too loose. Since degenerative joint conditions are characteristic of athletes and the aged, osteophytes are common in those with sports related injuries or arthritis. Conclusions: CBCT represents an improvement in quantifying the morphological changes of the condyle and mandible. The accurate and early diagnosis of JIA and the sensitive monitoring of the disease process are essential. Advanced imaging technology capable of identifying even the slightest trace of erosive joint damage may enable the prediction of future structural and functional deterioration.