Article

MR imaging of temporomandibular joint dysfunction: a pictorial review.

Department of Radiology, Hospital Clínic, Facultat de Medicina, Universitat de Barcelona, Villarroel 170, Barcelona 08036, Spain.
Radiographics (impact factor: 2.85). 26(3):765-81. DOI:10.1148/rg.263055091 pp.765-81
Source: PubMed

ABSTRACT Temporomandibular joint (TMJ) dysfunction is a common condition that is best evaluated with magnetic resonance (MR) imaging. The first step in MR imaging of the TMJ is to evaluate the articular disk, or meniscus, in terms of its morphologic features and its location relative to the condyle in both closed- and open-mouth positions. Disk location is of prime importance because the presence of a displaced disk is a critical sign of TMJ dysfunction. However, disk displacement is also frequently seen in asymptomatic volunteers, so that other findings may be required to help make the diagnosis. These findings include thickening of an attachment of the lateral pterygoid muscle, rupture of retrodiskal layers, and joint effusion and can serve as indirect early signs of TMJ dysfunction. It is important for the radiologist to detect early MR imaging signs of dysfunction, thereby avoiding the evolution of this condition to its final stage, an advanced and irreversible phase that is characterized by osteoarthritic changes such as condylar flattening or osteophytes. Further studies conducted with the latest MR imaging techniques will allow a better understanding of the sources of TMJ pain and of any discrepancy between imaging findings and patient symptoms.

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    Article: Biometric parameters of the temporomandibular joint and association with disc displacement and pain: a magnetic resonance imaging study.
    I Vieira-Queiroz, M G Gomes Torres, C de Oliveira-Santos, P S Flores Campos, I M Crusoé-Rebello
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    ABSTRACT: The aim of this study was to evaluate the relationship between biometric parameters of the components of the temporomandibular joint (TMJ), articular disc displacement, and TMJ pain. Magnetic resonance imaging (MRI) examinations of 185 patients were assessed (39 males and 146 females (370 TMJs), mean age 41.3 years, range 18-79 years). The antero-posterior length of the condyle was measured in its medial and lateral regions, as well as the transverse length of the condyle. Possible associations between linear measurements of the condyle, presence of disc displacement, and joint pain were tested. Although pain was more commonly reported among patients with disc displacements, this association was not statistically significant. We found statistically significant associations showing that the antero-posterior length of the condyle at the lateral pole (D1L), the antero-posterior length of the condyle at the medial pole (D1M), and the transverse length of the condyle (D2) were higher among patients without disc displacements when compared to those with unilateral or bilateral displacements. This study showed that disc displacement was associated with smaller condyles in the antero-posterior and transverse dimensions when compared to condyles in subjects with normal disc position.
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    Article: Risk of temporomandibular joint effusion related to magnetic resonance imaging signs of disc displacement.
    Bruno Orlando, Giacomo Chiappe, Nicola Landi, Mario Bosco
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    ABSTRACT: It has been suggested that TMJ effusion may represent an inflammatory response to a dysfunctional disc-condyle relationship. The purpose of the present study was to evaluate whether the status of the disc in the temporomandibular joint, as depicted in magnetic resonance (MR) images, is predictive of the presence of temporomandibular joint (TMJ) effusion. The relationship between disc displacement and TMJ effusion was analyzed in MR images of 154 TMJs in 77 patients complaining for pain and/or dysfunction in the TMJ area and referred from medical practitioners to specialist consultation. Logistic regression analysis was used to identify the significant correlation between presence/absence of joint effusion and disc displacement. Significant correlation (P<0.01) between disc displacement and joint effusion was found. OR for all type of disc displacement was 3.1, and the odds that a joint had magnetic resonance imaging findings of effusion was greater for anterior disc displacement without reduction. The status of the disc could represent a factor involved in the development of temporomandibular joint oedema. However, these findings suggest that disc displacement may not be regarded as the dominant factor in defining the occurrence of TMJ effusion. Certain local or systemic conditions other than the disc-condyle relationship must be considered.
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Keywords

articular disk
 
asymptomatic volunteers
 
common condition
 
condylar flattening
 
dysfunction
 
imaging findings
 
irreversible phase
 
lateral pterygoid muscle
 
latest MR imaging techniques
 
meniscus
 
morphologic features
 
MR imaging
 
MR imaging signs
 
open-mouth positions
 
osteoarthritic changes
 
patient symptoms
 
radiologist
 
retrodiskal layers
 
TMJ dysfunction
 
TMJ pain