The use of bone scintigraphy in temporomandibular joint disorders

Jb, Epstein; Rea, Anthony; Chahal, O

doi:10.1034/j.1601-0825.2002.10753.x

Cited by 28 publications

(18 citation statements)

References 22 publications

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“…Among them, the sensitivity of bone scan procedures is comparatively high; hence, it has been used as an effective diagnostic tool for TMD. 12 In bone scan procedures,…”

Section: Discussionmentioning

confidence: 99%

“…Numerous cases that have applied bone scan procedures for the evaluation of the TMJ such as the remodelling of the mandibular condyle, bone resorption and metastatic lesions have been reported. 12 However, although the sensitivity of bone scans is very high and lesions can be detected early, specificity is low and squamous cell carcinoma, chondrosarcoma, metastatic disease, eosinophilic granuloma, cysts, osteomyelitis, trauma, Paget's disease, metabolic disorders such as hyperthyroidism, fibrous dysplasia, osteoporosis, arthritis, bone graft and other diverse bone and soft tissue diseases may show identical results. Therefore, it is necessary to confirm diagnoses by combining the clinical findings of patients, other radiological results and symptoms.…”

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confidence: 99%

“…Uptake measurements depend on the blood flow volume and the amount of calcium contained in the phosphate binding sites on bone crystals; the uptake is increased in the areas where osteoblast activity is high with abundant blood flow. 12 It has been reported that in bone scans, the uptake rate is highest in younger patients and in menopausal women, the uptake in the cranial area is higher than that observed in non-menopausal women. 8, 13 Kigami et al 14 have reported that uptake rates are noticeably higher in females than in males.…”

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confidence: 99%

“…Epstein et al 12 have reported that bone scans are very useful to assess the stability of the TMJ and the presence or absence of active inflammatory reactions. Goldstein et al 7 have reported that for the diagnosis of deformities in the TMJ, bone scan is a better method than orthopantomography, transcranial radiography or tomography.…”

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Effectiveness of bone scans in the diagnosis of osteoarthritis of the temporomandibular joint

Kim

Yk²,

Kim³

et al. 2012

Dentomaxillofacial Radiology

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patients (4 males and 18 females) from Seoul National University Bundang Hospital, Republic of Korea, were diagnosed with TMJ disorder. They were examined by clinical examination, plain radiograph and bone scan and were categorized into three groups: normal, internal derangement and osteoarthritis. TMJ uptake ratios and asymmetrical indices were calculated. Results: There were no significant differences in uptake ratios associated with pain and bone change. However, significant results were obtained when comparing uptake ratios between the osteoarthritis and non-osteoarthritis groups. Conclusion: It was concluded from this study that bone scans may help to diagnose osteoarthritis when increased uptake ratios are observed. Dentomaxillofacial Radiology (2012) 41, 224-229. doi: 10.1259/dmfr/83814366 Keywords: osteoarthritis; temporomandibular joint; bone scan Introduction Osteoarthritis, previously referred to as the degenerative joint disease of the temporomandibular joint (TMJ), is a physical response to increased force on the TMJ and refers to the degenerative state associated with secondary inflammation.1 Osteoarthritis occurs in most people, but is nonetheless more prevalent in females than in males and has been shown to be highly associated with increasing age.2 According to Dworkin and LeResche, 3 criteria for the diagnosis of osteoarthritis include the presence of pain, both subjective and palpatory, and auscultation of crepitus. Radiological characteristics such as structural changes, including erosion of the cortical bone of the condyle or mandibular fossa, sclerosis and flattening of the condyle, and osteophytes could also indicate a diagnosis of osteoarthritis.For the diagnosis of TMJ diseases, useful imaging techniques include plain radiological tests such as panoramic and transcranial radiography, tomography, arthrography, CT and MRI. 4,5 Nuclear medical test methods include bone scan and single photon emission CT (SPECT).1 However, plain radiography has some limitations, including the fact that it cannot evaluate the centre and medial side of the condyle and that a difference in bone mineral content of at least 30-50% is required for the detection of a bone lesion.6,7 Bone scans show positive detectable signals even with the increase in osteoblast activity of approximately 10%, and their sensitivity is very high, making bone scans advantageous for the early diagnosis of lesions. However, the specificity of bone scans is relatively low. 8,9 Standard radiography has several limitations for the evaluation of the bone structure of the TMJ. Nonetheless, after the diagnosis of osteoarthritis based on previous clinical assessment and radiography, if bone scan results are applied as an additional diagnostic tool, an accurate and rapid diagnosis can be made and treatment could be initiated more quickly. In our study, the association of diagnosis based on clinical symptoms and general radiographs with the results of bone scan was examined. 10 In patients with symptoms of joint noise during normal function, m...

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“…Among them, the sensitivity of bone scan procedures is comparatively high; hence, it has been used as an effective diagnostic tool for TMD. 12 In bone scan procedures,…”

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Effectiveness of bone scans in the diagnosis of osteoarthritis of the temporomandibular joint

Kim

Yk²,

Kim³

et al. 2012

Dentomaxillofacial Radiology

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“…Therefore, areas of smooth blood circulation have a high activation of osteoblasts and high TMJ hot spot value compared to other areas where blood circulation is not smooth 12) .…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of Temporomandibular Joint Disorder Follow-Up Using Bone Scans

Ku¹,

Kim²,

Yun³

2015

Journal of Korean Dental Science

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cc This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/ by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.Purpose: To evaluate the effectiveness of temporomandibular joint (TMJ) disorder follow-up and determine the factors that affect the TMJ bone scan hot spot numerical value (bone scan value), and to compare this value to the diagnosis of patients with temporomandibular joint disorders (TMD), their treatment options, and the resolution of their symptoms. Materials and Methods:A retrospective cohort study was performed on 24 patients (four males, 20 females) who received TMD treatment in the Section of Dentistry, Seoul National University Bundang Hospital (Seongnam, Korea) from 2007 to 2014. An analysis of the significance test and correlation between TMD diagnosis, treatment options, a baseline the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) questionnaire, treatment before and after the clinical examination and subjective progress, and TMJ bone scan value change were completed by using SPSS version 12.0.Result: Although only 14 patients had bony factors that caused TMD, the average pre-treatment bone scan value of the all patients was 4.29±0.31, which is higher than the finding for osteoarthritis (3.88), and reduced post-treatment bone scan value was found to be without a statistically significant difference (P=0.056). After the treatments, clinical symptoms in 18 patients disappeared, and six patients did not require additional treatment, although they still displayed subjective symptoms. It was observed that the higher the pre-treatment bone scan value, nonspecific physical symptoms, chronic pain index, characteristic pain intensity, disability score, were, the lower the posttreatment bone scan value was. And this reduced post-treatment bone scan value tendency was not shown with the pre-treatment depression index, but there was not a statistical difference. Conclusion:The post-treatment TMJ bone scan value tended to be insignificantly reduced in the 24 patients whose clinical symptoms were improved (P=0.056). Moreover, the TMJ bone scan value showed no relation to the TMD type or its related symptoms.

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Prediction of painful temporomandibular joint osteoarthritis in juvenile patients using bone scintigraphy

Lee

Hong

Chun

2019

Clinical & Exp Dental Res

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The study aims to evaluate whether bone scintigraphy is effective in diagnosing temporomandibular joint (TMJ) osteoarthritis (OA) in juvenile patients. A retrospective study was conducted with 356 consecutive patients with TMJ–OA who were clinically assessed according to the Research Diagnostic Criteria for Temporomandibular Disorders. Patients were assigned to three groups based on their ages: Group 1: aged 12–16 years; Group 2: aged 17–19 years; and Group 3: aged 20 years. Additionally, we performed qualitative and quantitative analyses of bone scintigraphy images for the TMJ uptake ratio of the involved joint. The diagnostic rate of TMJ–OA (n = 356, 100%), and the overall presence of subjective pain (n = 282, 77.3%) was closest to the results of bone scintigraphy (n = 333, 91.2%). In addition, reported TMJ pain was significantly associated only with the results of bone scintigraphy and not with the results of panoramic radiography or cone beam computed tomography (CBCT) in all age groups. With CBCT as the reference standard, the optimal cutoff values of the uptake ratio for the diagnosis of TMJ–OA were 2.171 and 2.017 in Groups 1 and 2, respectively (P value < 0.05). Our results suggest that bone scintigraphy can be considered a useful modality for diagnosing TMJ–OA in juvenile patients.

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The use of bone scintigraphy in temporomandibular joint disorders

Cited by 28 publications

References 22 publications

Effectiveness of bone scans in the diagnosis of osteoarthritis of the temporomandibular joint

Effectiveness of bone scans in the diagnosis of osteoarthritis of the temporomandibular joint

Effectiveness of Temporomandibular Joint Disorder Follow-Up Using Bone Scans

Prediction of painful temporomandibular joint osteoarthritis in juvenile patients using bone scintigraphy

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