C. Landes et al., Sonography of the temporomandibular joint from 60 examinations and comparison with MRI and axiography, J CRAN MAX, 28(6), 2000, pp. 352-361
Background and Objective: Establishing a diagnosis of temporomandibular joi
nt disorder is mainly based on clinical assessment, functional examination,
nuclear magnetic resonance imaging (MRI) and axiography. Sonographic exami
nation was compared with MRI and axiography in assessing temporomandibular
joint (TMJ) function in 55 patients. Patients and Methods: Fifty-five patie
nts with different TMJ problems were examined clinically, by means of axiog
raphy, sonography and some also by MRI, The range of motion was measured by
sonography and axiography and the results compared using Student's t-test,
Anatomical details diagnostic for disc-displacement were tested by sonogra
phy and MRI, Results: The average time required for sonography was 2 min an
d for axiography 20 min. The mean measurement differences for condylar move
ment in maximal mouth opening was 1.7 mm, for protrusion 1.6 mm and for med
iotrusion 2.5 mm, The range of condylar movement as measured by sonography
and axiography coincided for opening and for protrusion (statistically sign
ificant), No significance was found for lateral excursions. The concordance
in diagnosis of disc dislocation, hypermobility and impaired range of moti
on when comparing ultrasound with MRI was 83%, All sonographic examinations
were performed by one person only. Sixty repeat examinations in patients p
roduced no complaints and showed an absolute range of difference of 0.6 mm,
with a relative range of 7%, Student's t-test was significant (p<0.05) (tw
o repetitive measurements). Conclusion: Sonography proved to be a fast and
reliable method for evaluating the range of movement of the TMJ, The latera
l joint capsule, lateral disc, and upper condyle could be demonstrated. Pat
hological processes such as anterior or lateral disc displacement, disc per
foration, seroma following contusion, capsular fibrosis, crystalline struct
ures in the synovia and fracture dislocation of the condyle could be diagno
sed with considerable reliability when compared with MRI, However, the medi
al aspect of the joint, medial disc dislocation and the angulation of the c
ondylar slope could not be seen. <(c)> 2000 European Association for Cranio
-Maxillofacial Surgery.