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Sự tham gia của khớp thái dương hàm trong viêm khớp thiếu niên vô căn: Những thách thức trong chẩn đoán, điều trị và kết quả
Tóm tắt
Viêm khớp thiếu niên vô căn (JIA) là loại viêm khớp phổ biến nhất ở trẻ em. Sự biểu hiện của viêm khớp tại khớp thái dương hàm (TMJ) đặt ra những thách thức độc đáo trong chẩn đoán và điều trị. Bài tổng quan này phân tích một cách phê bình tài liệu gần đây, nhấn mạnh những phát hiện mới và đưa ra hướng dẫn về các thực hành lâm sàng gây tranh cãi. Hình ảnh học: Chụp cộng hưởng từ với thuốc tương phản gadolinium (Gd-MRI) là tiêu chuẩn vàng hiện nay cho việc chẩn đoán. Một hệ thống đánh giá TMJ-MRI mới đã được phát triển bởi nhóm nghiên cứu JIA của Omeract. Khám lâm sàng: Các khuyến nghị về khám lâm sàng khuôn mặt đồng thuận để theo dõi bệnh nhân đã được phát triển và đang được xác thực. Điều trị: Việc điều trị viêm khớp TMJ bao gồm thuốc điều trị tại chỗ và toàn thân, điều trị với các thiết bị chỉnh hình và có khả năng phẫu thuật hàm mặt. Một hệ thống đánh giá Gd-MRI mới và các khuyến nghị khám lâm sàng để đánh giá viêm khớp TMJ ở các bệnh nhân JIA đã được cung cấp, cho phép các bác sĩ so sánh bệnh nhân và phản ứng điều trị. Các tiêm trong khớp chỉ nên được sử dụng ở một số bệnh nhân nhất định với sự thận trọng. Một sự kết hợp giữa thuốc toàn thân và thiết bị chỉnh hình là cần thiết để điều trị những bệnh nhân này, đòi hỏi một cách tiếp cận đa ngành.
Từ khóa
#Viêm khớp thiếu niên vô căn #khớp thái dương hàm #chẩn đoán #điều trị #phẫu thuật hàm mặtTài liệu tham khảo
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