Temporomandibular joint (TMJ) disc position in patients with TMJ pain assessed by coronal MRI

Abstract

Objectives: To assess the position of the temporomandibular joint (TMJ) disc in patients with TMJ pain and compare it with equivalent published data of asymptomatic volunteers. Methods: The oblique coronal closed-and open-jaw MR images from 66 patients with TMJ pain were evaluated. Clinical examination followed the research diagnostic criteria for temporomandibular disorders. In all coronal images, the transverse condylar axis and the medial and lateral edges of the disc were determined using special software. Inter-rater agreement was calculated [two raters; inter-rater correlation coefficient (ICC)]. The presence of osteoarthrosis (OA) was determined by two independent raters. The influence of OA was estimated in patients (generalized estimation equation model). The results were compared with those of healthy volunteers (t-test). Differences between closed and open jaw in patients were analysed with the Wilcoxon matched-pair test. Results: The ICC was good for the transverse condylar axis (0.987) and the medial edge of the disc (0.799) and fair for the lateral edge (0.355). On average, the disc projected 5.5% to the medial side; laterally, the condyle was partially uncovered by the disc (216.6%). In the openjaw position, both the medial and the lateral edges shifted medially (to 17.6% vs 223.6%, Wilcoxon matched-pair test, p , 0.001). OA had no significant influence (generalized estimation equation model, p 5 0.952). The disc position differed significantly from asymptomatic individuals (t-test, p , 0.001) who showed a medial disc position and full coverage of the condyle. Conclusions: In patients with TMJ pain, the disc seems to be smaller and located less medially than in healthy volunteers. The extent of the medial shift on opening was similar.

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

“…These findings confirm the results reported by Cholitgul et al [46]. However, Eberhard et al [47] expressed opposition to these findings. Many studies have supported the idea that joint effusion, defined as a large collection of fluid in the articular space, is generally associated with TMJ pain and inflammatory responses [10,[48][49][50][51][52].…”

Assessment of articular disc displacement of temporomandibular joint with ultrasound

“…Few studies described that the coronal plane of MR imaging is the ideal plane for assessment of the integrity of the congruency of the disc in the medial-lateral dimension and detection of sideway displacement [7][8][9][10]. In this work, coronal section of MR as transverse section at ultrasound in the opened mouth is the best plane for assessment of the sideway displacement.…”

“…Sideway displacement is commonly associated with variable degree of anterior disc displacement and it is therefore classified as either antero-medial or anterolateral displacement. Few studies have been discussing the value of MR imaging at coronal plane in diagnosis of sideway displacement of TMJ [7][8][9][10].…”

Retrospective magnetic resonance imaging study of risk factors associated with sideways disk displacement of the temporomandibular joint

“…Third, evaluation of mediolateral disk position was qualitative. Eberhard et al (22) reported that quantitative evaluation of mediolateral disk position more accurately described the relationship between mediolateral disk position and other variables, including the angle of the LPM relative to the condyle. Additional studies, with larger numbers of participants, are needed in order investigate the complex pathologies of anterior and sideways disk displacement of the TMJ.…”