Journal of Oral Medicine and Pain

Korean Academy of Orofacial Pain and Oral Medicine (대한안면통증구강내과학회)
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A Pilot Study on the Usefulness of Tomography and Bone Scan in Diagnosis of Patients with TMJ Osteoarthritis

측두하악관절 골관절염 환자의 진단에서 단층촬영과 골스캔 검사의 유용성에 대한 예비연구

  • Kim, Cheul (Department of Oral Medicine & Diagnosis, College of Dentistry, and Research Institute of Oral Science, Gangneung-Wonju National University) ;
  • Kim, Young-Jun (Department of Oral Medicine & Diagnosis, College of Dentistry, and Research Institute of Oral Science, Gangneung-Wonju National University) ;
  • Moon, Ji-Hoi (Department of Maxillofacial Biomedical Engineering, School of Dentistry, and Institute of Oral Biology, Kyung Hee University) ;
  • Park, Moon-Soo (Department of Oral Medicine & Diagnosis, College of Dentistry, and Research Institute of Oral Science, Gangneung-Wonju National University)
  • 김철 (강릉원주대학교 치과대학 구강내과.진단학교실 및 구강과학연구소) ;
  • 김영준 (강릉원주대학교 치과대학 구강내과.진단학교실 및 구강과학연구소) ;
  • 문지회 (경희대학교 치의학전문대학원 악안면생체공학교실 및 경희대학교 구강생물학연구소) ;
  • 박문수 (강릉원주대학교 치과대학 구강내과.진단학교실 및 구강과학연구소)
  • Received : 2012.04.09
  • Accepted : 2012.05.07
  • Published : 2012.06.30
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Abstract

TMJ Osteoarthritis is a degenerative disease caused by overload on joint tissue, and often accompany with local tenderness on the joint, crepitus by mandibular movement, restriction of mandibular movement, and anterior openbite. In general, panoramic radiography, TMJ panoramic radiography, and transcranial radiography are conducted to diagnose osteoarthritis after clinical examination, however, these radiographic evaluations are limited in detecting minute bony changes of early pathologic lesion. The aim of this pilot study was to evaluate the limitation and usefulness of several TMJ imaging techniques, so we compare the findings from clinical examination, plain film radiographs, tomograph, and bone scan from 81 patients with temporomandibular joint disorder. The proportion of patients showing same findings in plain film radiographs, TMJ tomograph, and bone scan was high, however, it is desirable that clinician should conduct phased imaging examinations according to the clinical findings due to the possibilities of false negative findings in diagnosis of osteoarthritis.

측두하악관절 골관절염은 관절조직에 가해지는 과부하에 의해 관절면과 하부 골조직에서 일련의 퇴행성과정과 함께 관절부의 국소적 압통, 하악운동에 의한 관절의 염발음, 하악의 운동범위 제한, 심한 경우에는 과두지지가 없어져 구치부 과다접촉과 전치부 개교합이 나타날 수 있는 퇴행성질환이다. 일반적으로는 임상검사 후 파노라마방사선사진, 측두하악관절 파노라마, 경두개방사선사진을 촬영한 뒤 진단하게 되는데 이들 일반적인 방사선사진들은 질환 초기의 미세한 골변화를 평가하는데 제한적이다. 따라서 본 연구에서는 일반방사선학적 검사에서 골조직의 퇴행성변화가 의심되어 확진을 위해 단층촬영 및 골스캔 검사를 시행한 환자의 영상의학적 검사소견들 간의 일치도와 임상소견과의 관계를 평가하여 골관절염의 진단에서 이들 다양한 검사법들의 한계와 그 유용성을 평가하고 향후 추가연구를 위한 예비자료를 얻기위해 시행하였다. 골관절염의 진단에서 일반방사선사진과 단층촬영, 골스캔 검사의 결과 일치도가 비교적 높게 나타났지만 위음성 가능성이 존재하므로 임상검사소견에 따른 단계적인 영상의학적 검사 시행이 바람직할 것으로 사료된다.

Keywords

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