MRI evidence of high signal intensity and temporomandibular arthralgia and relating pain. Does the high signal correlate to the pain?

Murakami, Ken-Ichiro; Nishida, Mitsuo; Iizuka, Tadahiko; Tsuda, Yukiyoshi; Konishi, Junji

doi:10.1016/s0266-4356(96)90273-9

Cited by 70 publications

(41 citation statements)

References 6 publications

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“…When a systematic correlation between different stages of internal derangement and pain was made, an association with joint effusion and pain was found . This association has been questioned [Murakami et al, 1996], but confi rmed by others [Rudisch et al, 2001;Larheim et al, 2001c;Yano et al, 2004].…”

Section: Internal Derangement and Joint Effusionmentioning

confidence: 95%

Role of Magnetic Resonance Imaging in the Clinical Diagnosis of the Temporomandibular Joint

Larheim¹

2005

Cells Tissues Organs

165

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Temporomandibular joint (TMJ) abnormalities cannot be reliably assessed by a clinical examination. Magnetic resonance imaging (MRI) may depict joint abnormalities not seen with any other imaging method and thus is the best method to make a diagnostic assessment of the TMJ status. In patients with temporomandibular joint disorder (TMD) referred for diagnostic imaging the predominant TMJ finding is internal derangement related to disc displacement. This finding is significantly more frequent than in asymptomatic volunteers, and occurs in up to 80% of patients consecutively referred for TMJ imaging. Moreover, certain types of disc displacement seem to occur almost exclusively in TMD patients, namely complete disc displacements that do not reduce on mouth opening. Other intra-articular abnormalities may additionally be associated with the disc displacement, predominantly joint effusion (which means more fluid than seen in any asymptomatic volunteer) and mandibular condyle marrow abnormalities (which are not seen in volunteers). These conditions seem to be closely related. Nearly 15% of TMD patients consecutively referred for TMJ MRI will have joint effusion, of whom about 30% will show bone marrow abnormalities. In a surgically selected material of joints with histologically documented bone marrow abnormalities nearly 40% showed joint effusion. Disc displacement is mostly bilateral, but joint effusion seems to be unilateral or with a lesser amount of fluid in the contralateral joint. Abnormal bone marrow is also mostly unilateral. Many patients have unilateral pain or more pain on one side. In a regression analysis the self-reported in-patient TMJ pain side difference was positively dependent on TMJ effusion and condyle marrow abnormalities, but negatively dependent on cortical bone abnormalities. Of the joints with effusion only one fourth showed osteoarthritis. Thus, there seems to be a subgroup of TMD patients showing more severe intra-articular pathology than disc displacement alone, and mostly without osteoarthritis. It should, however, be emphasized that patients with TMJ effusion and/or abnormal bone marrow in the mandibular condyle seem to constitute only a minor portion (less than one fourth) of consecutive TMD patients referred for diagnostic TMJ imaging. The majority of patients have internal derangement related to disc displacement, but without accompanying joint abnormalities. In patients with rheumatoid arthritis and other arthritides TMJ involvement may mimick the more common TMDs. Using MRI it is possible, in most cases, to distinguish these patients from those without synovial proliferation.

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Section: Internal Derangement and Joint Effusionmentioning

confidence: 95%

Role of Magnetic Resonance Imaging in the Clinical Diagnosis of the Temporomandibular Joint

Larheim¹

2005

Cells Tissues Organs

165

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“…9 There are, however, several studies showing a weak correlation between JE and TMJ pain. 10,11 Furthermore, JE has also been detected in asymptomatic TMJs, with no observable pathology. 12 We also observed a predominance of female over male subjects, an observation consistent with a tendency reported in the related literature.…”

Section: Discussionmentioning

confidence: 99%

Assessing joint effusion and bone changes of the head of the mandible in MR images of symptomatic patients

Oliveira¹,

Rosa²,

Dutra³

et al. 2013

Braz. oral res.

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The aim of the present study was to investigate the relationship between degenerative bone changes of the head of the mandible and the presence of joint effusion (JE). This study was based on sagittal magnetic resonance imaging (MRI) reports of 148 temporomandibular joints (TMJs) of 74 patients complaining of pain and/or dysfunction in the TMJ area. The mandible heads were surveyed for osteoarthritis characteristics, which were classified as osteophytosis, sclerosis or erosion. The presence of JE was checked whenever high signal intensity was observed in the articular space. The results evidenced the presence of bone changes in 30% of the sample. Osteophytes and erosions were the changes most commonly observed. JE was reported in 10% of TMJs. The results from the statistical tests revealed that bone changes in the head of the mandible are associated with the presence of JE.

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“…Effusionen zeigen sich zumeist im lateralen Gelenkbereich und im anterosuperioren Gelenkraum mit einer prozentualen Häufigkeit im Patientenkollektiv um 20%, wobei aber auch Angaben von 13 und 88% vorliegen [4,12,41 69,95,97]. Inwiefern Effusionszeichen Ausdruck eines entzündlichen und/oder degenerativ-arthrotischen Vorgangs im Gelenkbinnenraum oder lediglich einer Ansammlung (vermehrter) Gelenkflüssigkeit sind, ist derzeit noch nicht abschließend geklärt [28,69,99,108]. Ergebnisse einer ersten Studie, die Effusionsmerkmale mit arthroskopischen Befunden bei uni-bzw.…”

Section: Effusionunclassified

Bildgebende Diagnostik bei Schmerzsymptomatik im Kiefergelenkbereich

Hugger

2002

Schmerz

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In the literature there exist some references to and indications for an association between TMJ pain and structure-based findings on TMJ images, i.e. morphology of the condyle, condyle-fossa relationship, form and position of the disc, signs of effusion of the upper resp. lower joint compartment, bone marrow signal abnormalities of the condyle, signal characteristics of the retrodiscal tissue. Despite some hints the relation between TMJ pain and so-called abnormalities on TMJ images remains unclear, complex and little predictive in individual cases.

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MRI evidence of high signal intensity and temporomandibular arthralgia and relating pain. Does the high signal correlate to the pain?

Cited by 70 publications

References 6 publications

Role of Magnetic Resonance Imaging in the Clinical Diagnosis of the Temporomandibular Joint

Role of Magnetic Resonance Imaging in the Clinical Diagnosis of the Temporomandibular Joint

Assessing joint effusion and bone changes of the head of the mandible in MR images of symptomatic patients

Bildgebende Diagnostik bei Schmerzsymptomatik im Kiefergelenkbereich

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