Internal derangement of the temporomandibular joint: is there still a place for ultrasound?
OBJECTIVE
The aim of this study was to assess the diagnostic value of articular sounds, standardized clinical examination, and standardized articular ultrasound in the detection of internal derangements of the temporomandibular joint.


METHODS
Forty patients and 20 asymptomatic volunteers underwent a standardized interview, physical examination, and static and dynamic articular ultrasound. Sensitivity, specificity, and predictive values were calculated using magnetic resonance as the reference test.


RESULTS
A total of 120 temporomandibular joints were examined. Based on our findings, the presence of articular sounds and physical signs are often insufficient to detect disk displacement. Imaging by static and dynamic high-resolution ultrasound demonstrates considerably lower sensitivity when compared with magnetic resonance. Some of the technical difficulties resulted from a limited access because of the presence of surrounding bone structures.


CONCLUSIONS
The present study does not support the recommendation of ultrasound as a conclusive diagnostic tool for internal derangements of the temporomandibular joint.
Dental Care Center, Montpellier University Hospital, UM 1, Montpellier, France. i-bonafe@chu-montpellier.fr
Isabelle
I
Dupuy-Bonafé
Marie-Christine
MC
Picot
Igor L
IL
Maldonado
Virginie
V
Lachiche
Isabelle
I
Granier
Alain
A
Bonafé
D000328:Adult; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D004204:Joint Dislocations / Q000000981:diagnostic imaging / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012015:Reference Standards; D012680:Sensitivity and Specificity; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D019224:Temporomandibular Joint Disc / Q000000981:diagnostic imaging* / Q000473:pathology*; D013705:Temporomandibular Joint Disorders / Q000000981:diagnostic imaging* / Q000473:pathology; D014463:Ultrasonography / Q000706:statistics & numerical data*; D055815:Young Adult