Temporomandibular joint internal derangement type III: relationship to magnetic resonance imaging findings of internal derangement and osteoarthrosis. An intraindividual approach.
The purpose of this study was to investigate whether in patients with a clinical unilateral temporomandibular joint (TMJ)-related finding of internal derangement type (ID)-III (disk displacement without reduction) in combination with TMJ-related pain, the intraindividual variable of 'unilateral TMJ ID-III pain' may be linked to subject-related magnetic resonance (MR) imaging findings of TMJ ID, and TMJ osteoarthrosis (OA). The study comprised 48 consecutive TMJ pain patients, who were assigned a clinical unilateral TMJ pain side-related diagnosis of ID-III. Bilateral sagittal and coronal MR images were obtained to establish the presence or absence of TMJ ID and/or OA. Comparison of the TMJ side-related data showed a significant relationship between the clinical finding of TMJ ID-III pain and the MR imaging diagnoses of TMJ ID (P=0.000) and TMJ ID type (P=0.000). There was no correlation between the clinical finding of TMJ ID-III pain and the MR imaging diagnosis of TMJ OA (P=0.217), nor between the MR imaging diagnosis of TMJ OA and that of TMJ ID (P=0.350). Regarding the diagnostic subgroups of TMJ ID, a significant relationship was found between the presence of TMJ OA and the MR imaging diagnoses of TMJ ID type(P=0.002). Use of the Kappa statistical test indicated a fair diagnostic agreement between the presence of TMJ ID-III pain and the MR imaging diagnosis of disk displacement without reduction (DDNR) (K=0.42). The results suggest that TMJ ID-III pain is related to TMJ-related MR imaging diagnoses of ID. Further, the data confirm the biological concept of 'DDNR and OA' as an underlying mechanism in the etiology of TMJ-related pain and dysfunction.
Emshoff
R
R
Department of Oral and Maxillo-Facial Surgery, University of Innsbruck, Austria. Maxillofaziale-Chirurgie@uibk.ac.at
Rudisch
A
A
Innerhofer
K
K
Bösch
R
R
Bertram
S
S
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D003661:Decision Support Techniques; D005157:Facial Pain / Q000209:etiology; D005260:Female; D006801:Humans; D004204:Joint Dislocations / Q000175:diagnosis*; D008279:Magnetic Resonance Imaging; D008297:Male; D008335:Mandibular Condyle / Q000473:pathology; D008875:Middle Aged; D010003:Osteoarthritis / Q000175:diagnosis*; D016059:Range of Motion, Articular; D019224:Temporomandibular Joint Disc / Q000473:pathology; D013705:Temporomandibular Joint Disorders / Q000150:complications / Q000175:diagnosis*