Temporomandibular joint pain and associated magnetic resonance findings: a retrospective study with a control group

Abstract

Background To better understand and evaluate clinical usefulness of magnetic resonance imaging (MRI) in diagnosis and treatment of temporomandibular disorders (TMD), parameters for the evaluation are useful. Purpose To assess a clinically suitable staging system for evaluation of MRI of the temporomandibular joint (TMJ) and correlate the findings with age and some clinical symptoms of the TMJ. Material and Methods Retrospective analysis of 79 consecutive patients with clinical temporomandibular disorder or diagnosed inflammatory arthritis. Twenty-six healthy volunteers were included as controls. Existing data included TMJ pain, limited mouth opening (<30 mm) and corresponding MRI evaluations of the TMJs. Results The patients with clinical TMD complaints had statistically significantly more anterior disc displacement (ADD), disc deformation, caput flattening, surface destructions, osteophytes, and caput edema diagnosed by MRI compared to the controls. Among the arthritis patients, ADD, effusion, caput flattening, surface destructions, osteophytes, and caput edema were significantly more prevalent compared to the healthy volunteers. In the control group, disc deformation and presence of osteophytes significantly increased with age, and a borderline significance was found for ADD and surface destructions on the condylar head. No statistically significant associations were found between investigated clinical and MRI parameters. Conclusion This study presents a clinically suitable staging system for comparable MRI findings in the TMJs. Our results indicate that some findings are due to age-related degenerative changes rather than pathological changes. Results also show that clinical findings such as pain and limited mouth opening may not be related to changes diagnosed by MRI.

Relationship between Clinical Symptoms and Magnetic Resonance Imaging in Temporomandibular Disorder (TMD) Patients Utilizing the Piper MRI Diagnostic System

“…On the other hand, the finding of severe TMJs changes without any clinical symptoms except joint sounds motivates research into the causes of the functioning of the system, despite the deviations from the norm which are considered anatomically correct. Some previous studies has indicated a poor correlation between the severity of TMD-related pain complaints and the evidence of definitive tissue pathology [61][62][63]. The pain described by the authors of [64] was not related to the MR findings of effusion in the internal derangement and synovial fluid aspirate findings of the total protein concentration.…”

Psoriatic arthritis of the temporomandibular joint: A systematic review

“…Two studies were epidemiologic 26,27 ; two were observational. 28,29 Four studies reported MRI findings [30][31][32][33] ; and 32,33 reported US findings as well. Five studies included patients needing surgical procedures: TMJ replacement [34][35][36] ; TMJ reconstruction with prosthesis or grafting 37 and one study on the removal of an ankylotic block and condylar shaving.…”

“…Some authors evaluated the TMJ changes in PsA compared to a control group of patients (healthy patients or non-psoriatic cases) and showed that TMJ involvement was more frequently encountered in psoriatic patients. 26,28,30 Giancristoforo S. et al reported nine cases of psoriasis with TMJ involvement, aiming to highlight the TMJ involvement in the process of psoriasis, as well as evidence that TMJ could be the first manifestation of psoriasis. 26 In the psoriasis group, 40 patients out of sixty-one showed signs and symptoms of TMJ involvement, without PsA of any other joints and all patients with PsA presented TMJ clinical signs.…”

“…panoramic radiography and computed tomography of TMJs, 25 CT scans of her temporomandibular joints, 19,20,22,23,38 panoramic radiograph and CBCT images for advanced imaging of TMJs, 18,21 MRI 15,20,21,[30][31][32][33] and US. 32,33 MRI a considered the gold standard method, when compared to US examinations.…”

Effect of Disc Position for Acute Closed Lock of the Temporomandibular Joint

“…However, favorable MM outcomes were not achieved in certain patients despite the early implementation of MM, and the relationship between CL and MM outcomes remains unclear. Some reports suggest that the findings of imaging studies are not always consistent with clinical symptoms in real-world settings [4]. Diagnoses based on Magnetic Resonance Imaging (MRI) in patients with Temporomandibular Joint Disorder (TMD) tend to more closely correlate with clinical symptoms [5]; thus, accurately ascertaining the complete condition of disc position is crucial for the prognosis and evaluation of therapeutic outcomes [6].…”