Magnetic resonance imaging of synovial proliferation in temporomandibular disorders with pain.
OBJECTIVE
The objective of this study was to assess the clinical significance of synovial proliferation in patients with painful temporomandibular disorders based on magnetic resonance imaging findings.


METHODS
The current study was conducted in 100 joints of 100 patients with unilateral painful temporomandibular disorders. One hundred joints on the contralateral side of patients with unilateral disease were used as nonpain group. Areas in the articular space that showed a low signal intensity on T1-weighted imaging, a high signal intensity on T2-weighted imaging, and high signal intensity on gadolinium-enhanced fat-suppressed T1-weighted imaging were judged to be regions of synovial proliferation.


RESULTS
Synovial proliferation alone was observed in 8.0% of the pain group, but in none of the nonpain group. Synovial proliferation + effusion was observed in 33.0% of the pain group and in 7.0% of the nonpain group. Effusion alone was observed in 7.0% of the pain group and in 3.0% of the nonpain group. The mean visual analog scale value of pain was in the order of synovial proliferation alone > synovial proliferation + effusion > effusion alone. The incidence rates of anterior displacement of the disk were 100% for synovial proliferation alone, 93.9% for synovial proliferation + effusion, 57.1% for effusion alone, and 57.7% for "without synovial proliferation/effusion."


CONCLUSIONS
Strong correlations were observed between synovial proliferation, pain, and disk displacement. It is considered that evaluating effusion alone provides only limited information on the disease state in painful temporomandibular disorders. Thus, it is essential to include enhanced T1-weighted imaging as a means to judge the disease state as well as to assess disease progression.
Matsumura
Yoshihiko
Y
Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Mie University, 2-174 Edobashi, Tsu, Mie 514-8507, Japan. y-matsu@clin.medic.mie-u.ac.jp
Nomura
Jouji
J
Murata
Taku
T
Inui
Madoka
M
Nagai
Koyu
K
Yanase
Shigeaki
S
Nomura
Yoshiyuki
Y
Tagawa
Toshiro
T
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D006833:Hydrarthrosis / Q000150:complications / Q000175:diagnosis; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology; D013583:Synovial Membrane / Q000473:pathology*; D013704:Temporomandibular Joint / Q000473:pathology*; D013705:Temporomandibular Joint Disorders / Q000150:complications / Q000175:diagnosis / Q000473:pathology*
D003287:Contrast Media; C064925:gadodiamide; D019786:Gadolinium DTPA