Ultrasonography: A Step Forward in Temporomandibular Joint Imaging. A Preliminary Descriptive Study

Abstract

Ultrasonography (USG) is a cost-effective and noninvasive imaging modality commonly employed for imaging the abdominal region and extremities. Currently, with the availability of higher frequency probes and higher resolution devices, USG imaging of the temporomandibular joint (TMJ) looks promising. The aim is to evaluate and demonstrate the role of USG as an imaging modality of TMJ by visualizing the static and dynamic relationship of the joint, assessment of joint space and eliciting reproducibility at both open and closed mouth positions. 30 volunteers were selected based on the inclusion criteria in line with the research diagnostic criteria/temporomandibular disorders guidelines. High-resolution USG (≥12 MHz) of the right TMJ (chosen for uniformity) was done in the left decubitus position on (n=30) volunteers. The joint disc movement was directly visualized during opening and closing motions. The vertical joint space was assessed using the firmware and accurate reproducibility was checked. At the closed mouth position, the measured values ranged from 0.2 mm to 0.7 mm with a median of 0.05 cm and a mean of 0.4±0.15 mm. At the position of maximal mouth opening, the measured values ranged from 0.9 mm to 1.5 mm with a median of 1.1 mm and a mean of 1.1±0.17 mm. USG enables visualization of the dynamic relationship between joint structures, with particular importance to the condyle and disc position. The articular disc appears on the USG as a thin layer of hyperechogenicity surrounded by a hypoechoic halo, located between 2 hyperechoic lines viz, the condyle and the articular eminence. We recommend ultrasonographic imaging as a noninvasive diagnostic technique with relatively high specificity for patients with temporomandibular disorders.

An Algorithm for Jaw Pain among Divers

“…To confirm the clinical diagnosis, US is a viable option [ 29 ], but MRI, particularly dynamic MRI [ 30 ], is frequently the preferred imaging modality. Additionally, for patients who experience claustrophobia, open MRI scanners are available, offering a more comfortable imaging experience.…”

Diagnostic efficacy of quantitative ultrasonography for anterior disc displacement of the temporomandibular joint

“…As for the ultrasound techniques, a standardized protocol is required for better reproducibility and clinical feasibility. Previous studies had indicated that HR-US with a frequency higher than 12 MHz could differentiate the tissues in more detail and therefore achieve better diagnostic performance ( 20 , 21 ). The transducer was normally placed anterior to the tragus and oriented horizontally or longitudinally ( 7 , 8 , 13 ).…”

Orofacial Pain and Temporomandibular Joint Disorder: Chair-Side Routine Diagnostics (Radiography, Ultrasonography) and Mihalyi Ultrasonography Measured Splint Therapy, A Case Report

“…The diagnosis of the TMD can be very difficult. In other publications the ultrasonographic imaging diagnoses were compared with the clinical diagnosis, which showed total agreement, furthermore the ultrasonography presents high sensitivity and specificity in the identification of TMJ articular disc displacement as compared with MRI [5,15]. Radiography and ultrasonography diagnostic examinations can be a routine, chair-side tool which are non-invasive and economical procedures.…”

“…The correct diagnosis for treatment of TMD has an important part. The clinical examination is the first step which includes patient history, appearance of pain and joint sounds (clicks, pops, crepitus), palpation of oral masticatory muscles, and the range of the mandibular motion [5]. Furthermore, radiographic imaging is an important element in the diagnosis [6].…”