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Relationship between pain and effusion on magnetic resonance imaging in temporomandibular disorder patients

  • Park, Ha-Na (Department of Oral and Maxillofacial Radiology, School of Dentistry and Institute of Oral Bioscience, Chonbuk National University) ;
  • Kim, Kyoung-A (Department of Oral and Maxillofacial Radiology, School of Dentistry and Institute of Oral Bioscience, Chonbuk National University) ;
  • Koh, Kwang-Joon (Department of Oral and Maxillofacial Radiology, School of Dentistry and Institute of Oral Bioscience, Chonbuk National University)
  • 투고 : 2014.07.07
  • 심사 : 2014.09.17
  • 발행 : 2014.12.31

초록

Purpose: This study was performed to find the relationship between pain and joint effusion using magnetic resonance imaging (MRI) in temporomandibular disorder (TMD) patients. Materials and Methods: The study subjects included 232 TMD patients. The inclusion criteria in this study were the presence of spontaneous pain or provoked pain on one or both temporomandibular joints (TMJs). The provoked pain was divided into three groups: pain on palpation (G1), pain on mouth opening (G2), and pain on mastication (G3). MRI examinations were performed using a 1.5-T MRI scanner. T1- and T2-weighted images with para-sagittal and para-coronal images were obtained. According to the T2-weighted image findings, the cases of effusions were divided into four groups: normal, mild (E1), moderate (E2), and marked effusion (E3). A statistical analysis was carried out using the $X^2$ test with SPSS (version 12.0, SPSS Inc., Chicago, IL, USA). Results: Spontaneous pain, provoked pain, and both spontaneous and provoked pain were significantly related to joint effusion in TMD patients (p<0.05). However, among the various types of provoked pain, pain on palpation of the masticatory muscles and TMJ (G1) was not related to joint effusion in TMD patients (p>0.05). Conclusion: Spontaneous pain was related to the MRI findings of joint effusion; however, among the various types of provoked pain, pain on palpation of the masticatory muscles and TMJ was not related to the MRI findings of joint effusion. These results suggest that joint effusion has a significant influence on the prediction of TMJ pain.

키워드

참고문헌

  1. Emshoff R, Rudisch A. Validity of clinical diagnostic criteria for temporomandibular disorders: clinical versus magnetic resonance imaging diagnosis of temporomandibular joint internal derangement and osteoarthrosis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2001; 91: 50-5. https://doi.org/10.1067/moe.2001.111129
  2. Emshoff R, Brandlmaier I, Bertram S, Rudisch A. Relative odds of temporomandibular joint pain as a function of magnetic resonance imaging findings of internal derangement, osteoarthrosis, effusion, and bone marrow edema. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2003; 95: 437-45. https://doi.org/10.1067/moe.2003.95
  3. Bertram S, Rudisch A, Innerhofer K, Pumpel E, Grubwieser G, Emshoff R. Diagnosing TMJ internal derangement and osteoarthritis with magnetic resonance imaging. J Am Dent Assoc 2001; 132: 753-61. https://doi.org/10.14219/jada.archive.2001.0272
  4. Drace JE, Enzmann DR. Defining the normal temporomandibular joint: closed-, partially open-, and open-mouth MR imaging of asymptomatic subjects. Radiology 1990; 177: 67-71. https://doi.org/10.1148/radiology.177.1.2399340
  5. Haley DP, Schiffman EL, Lindgren BR, Anderson Q, Andreasen K. The relationship between clinical and MRI findings in patients with unilateral temporomandibular joint pain. J Am Dent Assoc 2001; 132: 476-81. https://doi.org/10.14219/jada.archive.2001.0210
  6. Rudisch A, Innerhofer K, Bertram S, Emshoff R. Magnetic resonance imaging findings of internal derangement and effusion in patients with unilateral temporomandibular joint pain. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2001; 92: 566-71. https://doi.org/10.1067/moe.2001.116817
  7. Emshoff R, Brandlmaier I, Bertram S, Rudisch A. Risk factors for temporomandibular joint pain in patients with disc displacement without reduction - a magnetic resonance imaging study. J Oral Rehabil 2003; 30: 537-43. https://doi.org/10.1046/j.1365-2842.2003.01111.x
  8. Yano K, Sano T, Okano T. A longitudinal study of magnetic resonance (MR) evidence of temporomandibular joint (TMJ) fluid in patients with TMJ disorders. Cranio 2004; 22: 64-71. https://doi.org/10.1179/crn.2004.008
  9. Larheim TA. Role of magnetic resonance imaging in the clinical diagnosis of the temporomandibular joint. Cells Tissues Organs 2005; 180: 6-21. https://doi.org/10.1159/000086194
  10. Emshoff R, Rudisch A. Temporomandibular joint internal derangement and osteoarthrosis: are effusion and bone marrow edema prognostic indicators for arthrocentesis and hydraulic distention? J Oral Maxillofac Surg 2007; 65: 66-73. https://doi.org/10.1016/j.joms.2005.11.113
  11. Guler N, Yatmaz PI, Ataoglu H, Emlik D, Uckan S. Temporomandibular internal derangement: correlation of MRI findings with clinical symptoms of pain and joint sounds in patients with bruxing behaviour. Dentomaxillofac Radiol 2003; 32: 304-10. https://doi.org/10.1259/dmfr/24534480
  12. Murakami K, Segami N, Fujimura K, Iizuka T. Correlation between pain and synovitis in patients with internal derangement of the temporomandibular joint. J Oral Maxillofac Surg 1991; 49: 1159-62. https://doi.org/10.1016/0278-2391(91)90407-D
  13. Takahashi T, Nagai H, Seki H, Fukuda M. Relationship between joint effusion, joint pain, and protein levels in joint lavage fluid of patients with internal derangement and osteoarthritis of the temporomandibular joint. J Oral Maxillofac Surg 1999; 57: 1187-94. https://doi.org/10.1016/S0278-2391(99)90483-4
  14. Ohlmann B, Rammelsberg P, Henschel V, Kress B, Gabbert O, Schmitter M. Prediction of TMJ arthralgia according to clinical diagnosis and MRI findings. Int J Prosthodont 2006; 19: 333-8.
  15. Adame CG, Monje F, Offnoz M, Martin-Granizo R. Effusion in magnetic resonance imaging of the temporomandibular joint: a study of 123 joints. J Oral Maxillofac Surg 1998; 56: 314-8. https://doi.org/10.1016/S0278-2391(98)90106-9
  16. Westesson PL, Brooks SL. Temporomandibular joint: relationship between MR evidence of effusion and the presence of pain and disk displacement. AJR Am J Roentgenol 1992; 159: 559-63. https://doi.org/10.2214/ajr.159.3.1503025
  17. Suenaga S, Abeyama K, Hamasaki A, Mimura T, Noikura T. Temporomandibular disorders: relationship between joint pain and effusion and nitric oxide concentration in the joint fluid. Dentomaxillofac Radiol 2001; 30: 214-8. https://doi.org/10.1038/sj.dmfr.4600610
  18. Smith HJ, Larheim TA, Aspestrand F. Rheumatic and nonrheumatic disease in the temporomandibular joint: gadoliniumenhanced MR imaging. Radiology 1992; 185: 229-34. https://doi.org/10.1148/radiology.185.1.1523314
  19. Segami N, Suzuki T, Sato J, Miyamaru M, Nishimura M, Yoshimura H. Does joint effusion on T2 magnetic resonance images reflect synovitis? Part 3. Comparison of histologic findings of arthroscopically obtained synovium in internal derangements of the temporomandibular joint. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2003; 95: 761-6. https://doi.org/10.1067/moe.2003.243
  20. Koh KJ, List T, Petersson A, Rohlin M. Relationship between clinical and magnetic resonance imaging diagnoses and findings in degenerative and inflammatory temporomandibular joint diseases: a systemic literature review. J Orofac Pain 2009; 23: 123-39.
  21. Barclay P, Hollender LG, Maravilla KR, Truelove EL. Comparison of clinical and magnetic resonance imaging diagnosis in patients with disk displacement in the temporomandibular joint. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1999; 88: 37-43. https://doi.org/10.1016/S1079-2104(99)70191-5
  22. Huddleston Slater JJ, Lobbezoo F, Chen YJ, Naeije M. A comparative study between clinical and instrumental methods for the recognition of internal derangements with a clicking sound on condylar movement. J Orofac Pain 2004; 18: 138-47.
  23. Usumez S, Oz F, Guray E. Comparison of clinical and magnetic resonance imaging diagnoses in patients with TMD history. J Oral Rehabil 2004; 31: 52-6. https://doi.org/10.1111/j.1365-2842.2004.01065.x
  24. Limchaichana N, Nilsson H, Ekberg EC, Nilner M, Petersson A. Clinical diagnoses and MRI findings in patients with TMD pain. J Oral Rehabil 2007; 34: 237-45. https://doi.org/10.1111/j.1365-2842.2006.01719.x
  25. Sano T, Westesson PL. Magnetic resonance imaging of the temporomandibular joint. Increased T2 signal in the retrodiskal tissue of painful joints. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1995; 79: 511-6. https://doi.org/10.1016/S1079-2104(05)80138-6
  26. Harms SE, Wilk RM, Wolford LM, Chiles DG, Milam SB. The temporomandibular joint: magnetic resonance imaging using surface coils. Radiology 1985; 157: 133-6. https://doi.org/10.1148/radiology.157.1.4034958
  27. Emshoff R, Brandimaier I, Bertram S, Rudisch A. Magnetic resonance imaging findings of osteoarthrosis and effusion in patients with unilateral temporomandibular joint pain. Int J Oral Maxillofac Surg 2002; 31: 598-602. https://doi.org/10.1054/ijom.2002.0314
  28. Emshoff R, Puffer P, Rudisch A, Gassner R. temporomandibular joint pain: relationship to internal derangement type, osteoarthrosis, and synovial fluid mediator level of tumor necrosis factor-alpha. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2000; 90: 442-9. https://doi.org/10.1067/moe.2000.108801
  29. Guler N, Uckan S, Imirzalioglu P, Acikgozoglu S. Temporomandibular joint internal derangement: relationship between joint pain and MR grading of effusion and total protein concentration in the joint fluid. Dentomaxillofac Radiol 2005; 34: 175-81. https://doi.org/10.1259/dmfr/49181266
  30. Nishimura M, Segami N, Kaneyama K, Suzuki T, Miyamaru M. Relationships between pain-related mediators and both synovitis and joint pain in patients with internal derangements and osteoarthritis of the temporomandibular joint. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2002; 94: 328-32. https://doi.org/10.1067/moe.2002.124106

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