Clinical and magnetic resonance imaging findings in temporomandibular joint disc displacement
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W Cholitgul1, H Nishiyama, T Sasai
1Department of Radiology, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand.
Objectives:
To describe the clinical and MRI findings in patients with disc displacement of the temporomandibular joint.
Methods:
Eighty-eight joints in 51 patients referred for suspected TMJ disc displacement were examined by MRI. Two oral radiologists assessed the images. The clinical findings were obtained by retrospective review of the patients' records.
Results:
Clicking was the most common clinical finding, present in 47 joints. Pain was reported for only 30 joints. Anterior disc displacement with reduction was found in 39 joints, anterior disc displacement without reduction in 31 joints, compound dislocations (anterolateral or anteromedial) in 13 joints and sideways displacement in 5 joints respectively. In about one-fourth of the joints, MRI revealed abnormal configuration of both disc and condyle. The osseous changes were subtle. Only 9% of the joints exhibited an osteophyte. Joint effusion in either the upper or the lower joint compartment was found in 19 joints. Out of 14 patients with joint effusion, six patients complained of pain from the TMJ region.
Conclusion:
The most extensive soft and hard tissue changes were found in patients with anterior disc displacement without reduction. Pain was not a characteristic symptom for any type of disc displacement.