Sonography of the temporomandibular joint from 60 examinations and comparison with MRI and axiography

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.