title: An experimental study of new diagnostic methods for the examination of osseous lesions in the temporomandibular joint.
abstract: Digital subtraction radiography, tomosynthesis, bone uptake of radionuclide, and arthroscopy were evaluated for detection and quantification of bony lesions induced unilaterally in the condyles of six dogs. A stereotaxic head-holder facilitated acquisition of reproducible radiographs suitable for subtraction and for circular tomosynthesis. Bone uptake of technetium-99m methylene diphosphonate was measured with a hand-held collimated miniature detector. Arthroscopy was performed with an arthroscope of 2.4 mm diameter. Bone defect mass determined by subtraction radiography correlated highly (r = 0.92, p less than 0.001) with the calcium content of removed bone measured by atomic spectroscopy. Both subtraction radiography and tomosynthesis indicated reshaping of the condyle into a more anterior position over a 10-week follow-up period. Radionuclide uptake was significantly elevated (p less than 0.04) from 2 to 10 weeks after surgery and correlated (r = 0.73, p less than 0.05) with regained bone mass measured by subtraction radiography. Arthroscopy revealed progressive degeneration of cartilage with denudation in the fossa. Both radiographic techniques demonstrated the lesions and bone remodeling, but only subtraction provided quantitative results. Radionuclide uptake predicted quantitatively future bone mass changes, and arthroscopy revealed cartilage and soft tissue status not otherwise observable.
authors.affiliation: Diagnostic Systems Branch, National Institute of Dental Research, National Institutes of Health, Bethesda, Md.
authors.forename: W
authors.initials: W
authors.lastname: Engelke
authors.forename: U E
authors.initials: UE
authors.lastname: Ruttimann
authors.forename: M
authors.initials: M
authors.lastname: Tsuchimochi
authors.forename: J D
authors.initials: JD
authors.lastname: Bacher
mesh_terms: D000818:Animals; D001182:Arthroscopy; D016723:Bone Remodeling; D004285:Dogs; D005069:Evaluation Studies as Topic; D005260:Female; D008335:Mandibular Condyle / Q000473:pathology; D011856:Radiographic Image Enhancement; D011877:Radionuclide Imaging; D013382:Subtraction Technique; D013669:Technetium Tc 99m Medronate; D013705:Temporomandibular Joint Disorders / Q000175:diagnosis* / Q000000981:diagnostic imaging; D014056:Tomography, X-Ray
chemical_list: D013669:Technetium Tc 99m Medronate