The relationship between clinical and MRI findings in patients with TMJ disoders at St. Vincent's hospital

ABSTRACT

Temporomandibular joint disorders(TMJD) have been associated with characteristic clinical findings such as pain, joint sound, and irregular or deviating jaw function. With the rapid progress in TMJ imaging techniques, magnetic resonance imaging(MRI) provides the clinician and researcher with a noninvasive technique with which to evaluate the anatomy of the temporomandibular joint, and its associated musculoskeletal structures. However, in terms of clinical decision-making there are only a few studies available concerned with the question of whether disc-condyle relationship is a significant factor in the onset of TMJrelated pain and dysfunction. The purpose of this study was to investigate whether patients with TMJ disorders related clinical symptoms classified as pain, mouth opening limitation, noise may be related to the MRI findings of TMJ internal derangement, effusion, bone change. Subjects consisted of 92 patients(184 TMJs) with unilateral and bilateral TMJ disorders at St. Vincent's Hospital. The contralateral, non-symptomatic TMJ(57 TMJs) served as the matched control. All patients underwent a complete stomatognathic examination that included palpation of both TMJs. No care was given and no anti-imflammatory medications were prescribed until bilateral MRIs were obtained. As for signs and symptoms related to TMJ disorders, the number of temporomandibular joints with pain alone is 54(61%), the biggest portion. The next one is mouth opening limitation which accounts for 17% out of the total. In addition, 86% of temporomandibular joints with clinical symptoms show abnormal conditions in MRI. According to MRI results of the temporomandibular joints, compound conditions of effusion, bone change and disc displacement account for 27%. And then, 49% of temporomandibular joints with non-symptom show abnormal condition in MRI. The results suggest that MRI may be used as diagnostic method for evaluating TMJ disorders and MRI finding of TMJ-related pain may be associated with effusion, bone change and disc displacement.