Temporomandibular disorders: relationship between joint pain and effusion and nitric oxide concentration in the joint fluid.
OBJECTIVE
To evaluate the relationship between joint effusion, contrast enhancement of effusion, nitric oxide concentration in TMJ fluid and TM joint pain.


METHODS
Nonenhanced T1- and T2-weighted and gadolinium-enhanced T1-weighted spin-echo sequences were performed in 77 patients with TMD. The nitric oxide concentration in TMJ fluid was analysed spectrophotometrically by the Griess reaction.


RESULTS
Some or marked effusion was seen in five (9%) of the 56 asymptomatic joints and in 55 (56%) of the 98 symptomatic joints. The prevalence of contrast enhancement of joint effusion was significantly higher in the joint pain group than in the joint sound or asymptomatic joint groups (chi2 test, P<0.001). On postcontrast T1-weighted images, there was no evidence of synovial proliferation in patients with TMD. Anterior disk displacement without reduction was detected in 93% of the TMJs with marked effusion. The degree of joint pain correlated with raised nitric oxide concentration (Spearman's rank correlation, P<0.05).


CONCLUSIONS
Painful joints are more likely to demonstrate contrast enhancement of joint effusion. Nitric oxide concentration in TMJ fluid is closely associated with inflammatory changes and painful TM joints.
Suenaga
S
S
Department of Dental Radiology, Kagoshima University Dental School, Sakuragaoka, Kagoshima City, Japan.
Abeyama
K
K
Hamasaki
A
A
Mimura
T
T
Noikura
T
T
D000293:Adolescent; D000328:Adult; D000368:Aged; D001168:Arthritis / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology*; D016009:Chi-Square Distribution; D003124:Colorimetry; D003287:Contrast Media; D005029:Ethylenediamines; D005260:Female; D016166:Free Radical Scavengers / Q000032:analysis*; D005682:Gadolinium; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007091:Image Processing, Computer-Assisted / Q000379:methods; D004204:Joint Dislocations / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D009569:Nitric Oxide / Q000032:analysis*; D013053:Spectrophotometry; D018709:Statistics, Nonparametric; D013424:Sulfanilamides; D013582:Synovial Fluid / Q000737:chemistry / Q000502:physiology*; D013583:Synovial Membrane / Q000473:pathology; D019224:Temporomandibular Joint Disc / Q000473:pathology; D013705:Temporomandibular Joint Disorders / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology*
D003287:Contrast Media; D005029:Ethylenediamines; D016166:Free Radical Scavengers; C095000:Griess reagent; D013424:Sulfanilamides; D009569:Nitric Oxide; D005682:Gadolinium