Lesions of the mandibular condyle in juvenile chronic arthritis.

A total of 371 serial dental panoramic radiographs from 71 children with juvenile chronic arthritis (JCA) were examined to determine the presence and extent of radiographically detectable condylar abnormalities. The series included 12 children with so called 'bird face' deformity and 55 in whom facial growth was judged to be normal. By the age of 15 years, 27 patients (38 per cent), showed lesions of the TMJ, of which 14 (55 per cent) were bilateral. Of those cases with unilateral destruction, the left condyle was affected nine times more frequently than the right. All of the children with 'bird face' deformity had condylar abnormality, but these facial characteristics should not be considered pathognomonic of juvenile chronic arthritis. Moderate to severe condylar abnormality was detectable in 10.9 per cent of children with normal facial growth, and where condylar destruction is present it can often be established as early as 8 years. Systemic corticosteroids appear to have little or no effect on the condyle or mandibular growth.