Retrodiscal tissue of the temporomandibular joint: clinical anatomy and its role in diagnosis and treatment of arthropathies

Langendoen, John; Müller, J.; Jull, Gwendolen

doi:10.1054/math.1997.0299

Cited by 13 publications

(5 citation statements)

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“…4 Functional MRI displaying normal condyle-disc relationship with normal disc mobility and morphology further supported this reasoning.…”

Section: Clinical Reasoning Assessment Fi Ndings Are Consistent With mentioning

confidence: 71%

“…Temporomandibular arthropathy and associated retrodiscal dysfunction were ruled out as a cause of symptoms via comprehensive functional assessment, specifi cally posterior-anterior and anterior-posterior mandibular accessory mobilisations (causing compressive forces in the strati and retrodiscal tissue). 4 Functional MRI displaying normal condyle-disc relationship with normal disc mobility and morphology further supported this reasoning.…”

Section: Case Historymentioning

confidence: 71%

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Integration of Rehabilitation and Acupuncture in the Treatment of a Professional Musician with Temporomandibular Joint Dysfunction

Hunter¹

2011

Acupunct Med

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This case study describes the use of acupuncture in a professional musician with myogenic temporomandibular dysfunction. The 3-year history of symptoms was associated with persistent episodic tension-type headaches. Acupuncture was used for trigger point release, primarily of the masticatory muscles, in conjunction with exercise therapy. After 8 weekly acupuncture sessions, the patient's pain had completely resloved, headaches had resolved and the Patient-Specifi c Functional Scale showed signifi cant improvements. INTRODUCTIONThe number of patient referrals to physiotherapy for treatment of temporomandibular dysfunction (TMD) is increasing; however, the evidence for specifi c treatment of this condition remains limited and inconclusive. This case illustrates that the use of acupuncture can be effective as part of an integrated treatment for the relief of myogenic temporomandibular joint (TMJ) dysfunction even when chronic, allowing the patient to return to the activity that precipitated the problem. CASE HISTORYWe describe the case of a 32-year-old full-time Army band player whose role involved playing the clarinet for up to 6 h/day (fi gure 1). She presented to physiotherapy in June 2010 with a 3-year history of TMD with referral to the lateral aspect of the neck and a long history of temporal headaches that required daily analgesia.Her pain was intermittent, did not follow a 24-h pattern and had two components (P1 and P2) as shown in fi gure 2. A Patient-Specifi c Functional Scale (PSFS) was used to assess her functional status.3 This patient-specifi c outcome measure involves the patients selecting activities that they have diffi culty with due to their condition and rating the functional limitation associated with these activities on a 0-10-point scale, with 0 being no pain and 10 being the worst pain. The client noted a PSFS of 3/10 when playing the clarinet for 30 min and a PSFS of 2/10 when talking, more specifi cally when shouting in a nightclub for 20 min. Due to the severity of her pain, she was unable to continue with her band duties, thus preventing her from carrying out her primary army work role.No particular mechanism of injury was noted; however, she did commence her career in the armed forces when the symptoms started. Previous physiotherapy treatment within the army had included manual therapy of the cervical spine and upper quadrant, which had been unsuccessful; she had also been using a lower soft occlusal splint at night since 2009, which had not improved any of her symptoms.Pain-relieving factors included heat and playing the clarinet out of the side of her mouth. The subject's secondary pain, P2, was associated with increasing P1. The patient also had a 2-year history of temporal headaches that was currently requiring daily doses of ibuprofen to manage. MRI revealed a normal appearance of the TMJ in the closed position with no mandibular condyle translation demonstrated on dynamic imaging. Her medical history was insignifi cant; however, she noted an incident 10 years ago in which...

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“…4 Functional MRI displaying normal condyle-disc relationship with normal disc mobility and morphology further supported this reasoning.…”

Section: Clinical Reasoning Assessment Fi Ndings Are Consistent With mentioning

confidence: 71%

Section: Case Historymentioning

confidence: 71%

Integration of Rehabilitation and Acupuncture in the Treatment of a Professional Musician with Temporomandibular Joint Dysfunction

Hunter¹

2011

Acupunct Med

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“…Our previous study indicated that the effectiveness of contrast enhancement with a T1-weighted FSE sequence was superior to that with a spoiled gradient-echo sequence [57]. In the synovial membrane tissue of the posterior disk attachment region and the TMJ capsule, more highly innervated and inflamed tissues are sources and causes of greater pain [58]. It has been reported that ADD WOR may produce more mechanical stress and stretch on the posterior disk attachment than ADD WR during the mouthopening movement, causing more painful TMDs [42].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the relationships between contrast-enhanced magnetic resonance characteristics and joint pain in patients with temporomandibular disorders

et al. 2015

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Objectives To evaluate the correlations between temporomandibular joint (TMJ) pain and both conventional and gadolinium-enhanced magnetic resonance (MR) imaging characteristics in patients with temporomandibular disorders (TMDs). Methods T1-weighted, T2-weighted, and fat-suppressed contrast-enhanced T1-weighted MR imaging were performed in 80 TMD patients with the main complaint of TMJ pain. A kappa statistical analysis was performed to calculate the interobserver agreement between two of three radiologists. The relationships between TMJ pain and various MR findings were analyzed by multiple comparison test, Spearman's rank correlation test, Chi-square test, Student's t test, and multivariate logistic regression analysis. Results Significant correlations were observed between anterior disk displacement without reduction, joint effusion, and TMJ pain (p \ 0.01). The degree of contrast enhancement of the posterior disk attachment was correlated with the severity of TMJ pain, especially spontaneous pain (r = 0.725, p \ 0.01), while no correlation was observed in the masticatory muscle pain group. The correlation tended to be higher in the latero-central portions than in the medial portion of the mandibular condyle, although no significant difference was seen. Conclusions It has been suggested that fat-suppressed contrast-enhanced MR imaging techniques facilitate better understanding of the sources of TMJ pain, but not masticatory muscle pain, and could reflect TMJ synovial inflammation. The severity of TMJ pain was closely correlated with the degree of contrast enhancement. The above-mentioned correlation had a tendency to be higher in the latero-central portions of the mandibular condyle.

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“…This may lead to dislocation without disc reduction (139). This retrodiscal lamina also is highly vascularized and innervated compared with the other components of the TMJ, making it a potential source of pain (77).…”

Section: Anatomy Reviewmentioning

confidence: 99%

Postrehabilitation Considerations for Individuals With Temporomandibular Disorders

Olivencia

Kaplan

Dreger

et al. 2021

Strength &Amp; Conditioning Journal

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Temporomandibular disorders (TMDs) encompass a multitude of signs and symptoms that arise from dysfunction of the muscles of mastication (eating), temporomandibular joint tissues, and associated anatomical structures. TMDs are recognized as a significant cause of orofacial pain, presenting in approximately 5-12% of the general population. TMDs are also common in sports with an estimated lifetime prevalence ranging from 11.7 to 77.8% of the athletic population. Basketball, handball, hockey, water polo, and swimming carry the highest risk. Given the prevalence of TMDs in the athletic and nonathletic population, there is a high likelihood that strength and conditioning (S&C) specialists will encounter individuals with TMDs. Thus, this article aims to provide the S&C specialist with an overview of the pathology and the management of TMDs with an emphasis on postrehabilitation exercise programming and selfmanagement.

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Retrodiscal tissue of the temporomandibular joint: clinical anatomy and its role in diagnosis and treatment of arthropathies

Cited by 13 publications

References 0 publications

Integration of Rehabilitation and Acupuncture in the Treatment of a Professional Musician with Temporomandibular Joint Dysfunction

Integration of Rehabilitation and Acupuncture in the Treatment of a Professional Musician with Temporomandibular Joint Dysfunction

Evaluation of the relationships between contrast-enhanced magnetic resonance characteristics and joint pain in patients with temporomandibular disorders

Postrehabilitation Considerations for Individuals With Temporomandibular Disorders

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