Clinical findings and associated MRI findings of temporomandibular joint disc degeneration

TL;DR

This study explores how symptoms of temporomandibular disorders relate to MRI findings of joint disc degeneration, finding that certain disc issues are linked to more severe symptoms.

Contribution

The study establishes a clearer link between specific MRI-detected TMJ disc degenerations and clinical symptoms, particularly highlighting displacement without reduction.

Findings

DDwoR was associated with higher prevalence of pain and osteoarthritis.

Trismus was more common in females compared to males (p = 0.04).

Disc thinning was the most frequent structural abnormality observed in TMJs.

Abstract

Background: Temporomandibular disorders (TMD) present with a wide
spectrum of symptoms, and many of these are linked to structural changes within
the temporomandibular joint (TMJ). Degenerative changes of the TMJ disc,
including thinning, perforation, and positional changes, are common in
symptomatic patients. MRI is the gold standard for evaluating soft tissues, but
the relationship between clinical findings and specific MRI-detected disc
degenerations remains unclear. This study aims to review the clinical symptoms
reported by patients with TMD and evaluate if these symptoms are linked to MRI
findings. Methods: Clinical examinations were conducted on patients
presenting with TMJ discomfort between September 2019 and December 2023.
Inclusion criteria were patients with suspected TMD who underwent bilateral TMJ
MRI with both open- and closed-mouth scans. Exclusion criteria included history
of head and neck radiotherapy, previous TMJ treatment or maxillofacial surgery,
presence of intense artifacts, and lack of both open- and closed-position TMJ MRI
scans. 180 TMJs from 90 patients (60 females, 30 males; mean age 33.5 years,
range 15–59) were evaluated. Clinical symptoms such as pain, joint sounds, and
trismus were recorded, and MRIs were assessed for TMJ disc position, disc
displacement degree, disc degeneration, and TMJ effusion. Results:
Statistically significant differences were found in trismus between sexes, with a
higher incidence in females (p = 0.04). MRI revealed 112 joints with
disc displacement with reduction (DDwR), 51 with displacement without reduction
(DDwoR), and 17 healthy joints. Structural abnormalities were observed in 104
TMJs (57.8%), most frequently disc thinning. Pain and osteoarthritis were
markedly more prevalent in DDwoR. Conclusions: This study confirmed
significant links between clinical symptoms and TMJ disc degeneration. DDwoR was
associated with more severe symptoms, including pain and osteoarthritis. MRI
remains essential for diagnosing TMJ disorders and guiding treatment. Further
prospective studies are needed to validate these findings.