The relationship between clinical and MRI findings in patients with unilateral temporomandibular joint pain

Background. With the advent of magnetic resonance imaging, or MRI, clinicia ns and researchers have sophisticated techniques by which to assess the ana tomy of the temporomandibular joint, or TMJ. Imaging is indicated when the results will affect the patients care beyond that which can be gained from a complete clinical assessment. One of the primary indications for treatmen t of patients with temporomandibular disorders or TMDs, is jaw pain, includ ingTMJ pain. Therefore, it is necessary to:assess whether MRI-depicted TMJ findings are associated with TMJ pain. This study assessed the relationship between TMJ pain and clinical and MRI findings. Methods. Subjects consisted of 85 patients with unilateral jaw pain in the area of the TJM. The:contralateral, nonpainful TMJ served as the matched co ntrol. ALL patients underwent a complete stomatagnathic examination that in cluded palpation of both TMJs. No care was given and no anti-inflammatory m edications were prescribed until bilateral MRIs were obtained within one we ek Results. The authors found significant, relationships between the side of r eported jaw pain and the patient's report that palpation of the TMJ was pai nful and between the side of reported pain and the presence of MRI-detected effusions. The authors found no relationship between the side of reported 1 pain and the presence of a disk displacement or DD, or between the presen ce of effusions and DD on either side of the jaw. Conclusion. Although MRI-depicted effusions of the TMJ were associated with reports of the TMJ pain, there was a high level of false positive and fals e-negative findings. The results indicate that palpation of the TMJ TMJ is more accurate than MRI-depicted effusions in identifying the TMJ as the sou rce of pain for patients with unilateral jaw pain. Clinical Implications. T he results of this study suggest that palpation of the TMJ is superior to M RI in identifying the joint as the source of pain. Therefore, the most cost ly effective and valid test to determine if the TMJ is a source of jaw pain is a complete clinical assessment.