INTERNAL DERANGEMENT OF THE TEMPOROMANDIBULAR-JOINT - CORRELATION OF ARTHROGRAPHIC IMAGING WITH SURGICAL FINDINGS

Sixty-seven patients, who were surgically treated for internal derange ment of the temporomandibular joint (TMJ), were retrospectively examin ed. The patients were evaluated preoperatively by clinical and arthrog raphic examinations and these results were compared with findings at s urgery. Partial or complete dislocation of the disc was detected by ar thrographic examination in 65 joints. Actual disc displacement was dem onstrated at surgery in 57 TMJs, giving arthrography a positive predic tive value of 88% for detecting disc dislocation. Arthrographic diagno sis of disc perforation was unreliable, as both false positive and fal se negative observations were recorded. Arthrography was found to have a positive predictive value of only 53% for assessing disc perforatio n. Based upon its proven inaccuracy, invasiveness and discomfort to th e patient, it is recommended to replace arthrography by magnetic reson ance imaging.