Facial asymmetry and mandibular hypomobility as early indicators of temporomandibular joint involvement in juvenile idiopathic arthritis.

Temporomandibular joint (TMJ) involvement in juvenile idiopathic arthritis (JIA) is often underrecognized. A comprehensive review highlights a frequent discrepancy between clinical symptoms and radiologic findings in TMJ arthritis among JIA patients. Key clinical indicators include facial asymmetry, limited mouth opening, and mandibular deviation. We present a case of a 9-year-old girl with JIA and no reported TMJ symptoms. Clinical assessment revealed facial asymmetry, mandibular deviation, and restricted mandibular mobility. Cone beam computed tomography showed the presence of unilateral condylar flattening and shortening of the mandibular ramus. This case underscores the importance of recognizing facial asymmetry and mandibular hypomobility as potential early indicators of TMJ arthritis in children with JIA, even in the absence of any symptoms or signs. Early detection through attention to subtle morphofunctional signs is imperative for improving patient outcomes in asymptomatic JIA cases.