Ultrasonographic Evaluation of Disc Displacement of the Temporomandibular Joint Compared With Magnetic Resonance Imaging

Çakır-Özkan, Nilüfer; Sarıkaya, Başar; Erkorkmaz, Ünal; Aktürk, Yeliz

doi:10.1016/j.joms.2009.08.010

Cited by 32 publications

(37 citation statements)

References 13 publications

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“…[21,[30][31][32][33]. To use ultrasonography for the diagnosis of a TMJ disorder, a clear understanding of disc displacement is necessary.…”

Section: Resultsmentioning

confidence: 99%

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Assessment of TMJ Disorders Using Ultrasonography as a Diagnostic Tool: A Review

Kundu¹

2013

JCDR

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“…[21,[30][31][32][33]. To use ultrasonography for the diagnosis of a TMJ disorder, a clear understanding of disc displacement is necessary.…”

Section: Resultsmentioning

confidence: 99%

“…Ozkan et al, found that the reproducibility, inter and intra-observer agreements of TMJ US were low and the authors advocated including two interpreters in the future studies [32].…”

Section: Wwwjcdrnetmentioning

confidence: 99%

Assessment of TMJ Disorders Using Ultrasonography as a Diagnostic Tool: A Review

Kundu¹

2013

JCDR

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“…High-resolution ultrasound was used for assessment of the anterior disc displacement of TMJ [14][15][16][17][18][19][20][21][22][23][24][25][26][27][28]. All these studies discuss the anterior displacement of the TMJ without assessment of sideway displacement of the disc.…”

Section: Introductionmentioning

confidence: 99%

Assessment of articular disc displacement of temporomandibular joint with ultrasound

et al. 2014

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Purpose To assess pattern of articular disc displacement in patients with internal derangement (ID) of temporomandibular joint (TMJ) with ultrasound. Materials and methods Prospective study was conducted upon 40 TMJ of 20 patients (3 male, 17 female with mean age of 26.1 years) with ID of TMJ. They underwent highresolution ultrasound and MR imaging of TMJ. The MR images were used as the gold standard for calculating sensitivity, specificity, accuracy, positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (PLR), and negative likelihood ratio (NLR) of ultrasound for diagnosis of anterior or sideway displacement of the disc. Results The anterior displaced disc was seen in 26 joints at MR and 22 joints at ultrasound. The diagnostic efficacy of ultrasound for anterior displacement has sensitivity of 79.3 %, specificity of 72.7 %, accuracy of 77.5 %, PPV of 88.5 %, NPV of 57.1 %, PLR of 2.9 and NLR of 0.34. The sideway displacement of disc was seen in four joints at MR and three joints at ultrasound. The diagnostic efficacy of ultrasound for sideway displacement has a sensitivity of 75 %, specificity of 63.6 %, accuracy of 66.7 %, PPV of 42.8, NPV of 87.5 %, PLR of 2.06, and NLR of 0.39. Conclusion We concluded that ultrasound is a non-invasive imaging modality used for assessment of anterior and sideway displacement of the articular disc in patients with ID of TMJ.Riassunto Scopo Valutare i pattern della dislocazione del disco articolare nei pazienti con squilibrio interno (ID) dell'articolazione temporo-mandibolare (ATM) con l'ecografia. Materiale e metodi E' stato condotto uno studio prospettico su 40 ATM di 20 pazienti (3 maschi, 17 femmine, con età media di 26,1 anni) con ID della TMJ. Tutti sono stati sottoposti ad ecografia ad alta risoluzione e RM della TMJ. La RM è stati utilizzata come il gold standard per il calcolo di sensibilità, specificità, accuratezza, valore predittivo positivo (PPV), valore predittivo negativo (NPV), rapporto di probabilità positivo (PLR) e rapporto di probabilità negativo (NLR) dell'ecografia nella la diagnosi di dislocazione anteriore o lateralmente del disco. Risultati Il disco appariva dislocato anteriormente in 26 ATM con la MR e in 22 con l'ecografia. L'efficacia diagnostica dell'ecografia nella diagnosi di dislocazione anteriore aveva sensibilità del 79,3 %, specificità del 72,7 %, accuratezza del 77,5 %, valore predittivo positivo del 88,5 %, NPV di 57,1 %, PLR di 2,9 e NLR di 0,34. Il dislocamento laterale del disco è stata osservato in 4 casi con MR e 3 con ecografia. L'efficacia diagnostica dell'ecografia per lo spostamento laterale aveva sensibilità del 75 %, specificità del 63,6 %, accuratezza del 66,7 %, PPV di 42,8, NPV di 87,5 %, PLR di 2.06 e NLR di 0,39. Conclusioni Abbiamo concluso che l'ecografia è una metodica di imaging non invasiva che può essere utilizzata per la valutazione delle dislocazioni anteriori e laterali del disco articolare nei pazienti con ID di TMJ.

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“…In this regard, we are in agreement with other authors, who have referred to the measurement of this hypoechoic area as the capsulecondyle distance. 3 Accurate depiction of the anatomic structures within the TMJ on sonography is essential when investigating the utility of sonography in the evaluation of this joint. It is particularly important given the growing literature on the use of TMJ sonography.…”

mentioning

confidence: 99%

Sonographic Evaluation of the Temporomandibular Joint: Uses and Limitations

Meyers

Oberle

2016

J of Ultrasound Medicine

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which was published earlier this year in the Journal of Ultrasound in Medicine. We agree with the authors on the importance of investigating sonography as an inexpensive and widely available imaging tool to supplement clinical examination findings in patients with suspected temporomandibular joint (TMJ) disorders. At our institutions, we currently have ongoing studies in the evaluation of the use of point-of-care sonography of the TMJ in pediatric patients with juvenile idiopathic arthritis.Our question and comment concerning the article published by Habashi et al 1 regards the accuracy in the depiction of the anatomy of the TMJ on their sonograms and how this anatomy corresponds to TMJ anatomy as seen on magnetic resonance imaging (MRI). First of all, in Figures 1-3, the authors do not indicate in the figure legends whether these are axial or coronal scan planes. 1 The first figure appears to be in the coronal plane given the appearance of the mandibular condyle; the second and third figures are more difficult to tell which scan plane is being used. We ask that the authors clarify this point.Second, and more importantly, what the authors are labeling as a normally positioned intra-articular disk in Figure 1 is superficial (closer to the transducer) to what they are labeling as the mandibular condyle. 1 We propose that if this structure truly were the intra-articular disk, it would not be normally positioned but would be laterally displaced. A normally located disk should be cranially positioned in relation to the mandibular condyle and would thus be located to the left of the condyle on the sonogram (left being more cranial assuming this is a coronal scan plane, but as mentioned above, the authors do not indicate the scan plane in the legend). 1,2 However, we believe that this structure is incorrectly labeled and is not in fact the intra-articular disk.In our experience, because the TMJ is bordered inferiorly by the mandibular condyle and superiorly by portions of the temporal bone, either the mandibular fossa (in the normal closed-mouth position) or the articular eminence (in the normal open-mouth position), sonograms only depict the lateral aspect of the joint because of dense shadowing deep to these bony structures, which obscures the central and medial portions of the joint. Therefore, if any portion of the intra-articular disk is visualized, it is only the lateral portion of the disk, which is located between the mandibular condyle and the temporal bone, unless there is lateral displacement of the disk. We have provided a figure with a coronal sonogram, which has been rotated to be in a similar orientation as a coronal MR image (see our Figure 1). We believe that the hypoechoic area lateral to the condyle, which Habashi et al 1 have labeled as the intraarticular disk, corresponds to the lateral extension of the joint capsule of the TMJ (see our Figure 1). In this regard, we are in agreement with other authors, who have referred to the measurement of this hypoechoic area as the capsulecondyle distance. 3 Acc...

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Ultrasonographic Evaluation of Disc Displacement of the Temporomandibular Joint Compared With Magnetic Resonance Imaging

Cited by 32 publications

References 13 publications

Assessment of TMJ Disorders Using Ultrasonography as a Diagnostic Tool: A Review

Assessment of TMJ Disorders Using Ultrasonography as a Diagnostic Tool: A Review

Assessment of articular disc displacement of temporomandibular joint with ultrasound

Sonographic Evaluation of the Temporomandibular Joint: Uses and Limitations

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