Association of Temporomandibular Joint Pain According to Magnetic Resonance Imaging Findings in Temporomandibular Disorder Patients

Abstract

This study investigated the associations between magnetic resonance imaging (MRI) findings and pain in the temporomandibular joint (TMJ). The study included 646 TMJs of 323 consecutive patients with temporomandibular disorders; of these, 222 (34.4%) had TMJ pain whereas 424 (65.6%) had no TMJ pain. MRIs were used to evaluate disc position, osteoarthritis, joint fluid, and bone marrow edema. Internal derangement was classified as normal, anterior disc displacement with reduction, and anterior disc displacement without reduction (ADDWOR); condylar morphology was classified as normal, moderate bony change, and severe bony change.The odds ratio (OR) for each MRI variable for nonpainful versus painful TMJs was computed using logistic regression analysis. Compared with joints with normal disc position, the OR of those with ADDWOR was 2.74 (P<.001) for TMJ pain. Similarly, compared with joints with normal condylar morphology, the OR of those with severe bony change was 4.62 (P=.02) for TMJ pain. In addition, the risk of TMJ pain increased by 2.37 in joints with joint fluid (P<.001) and by 2.34 in joints with bone marrow edema (P=.006). The risk of TMJ pain increased significantly with ADDWOR in combination with severe bony change, joint fluid, and bone marrow edema. These results suggest an association between TMJ pain and ADDWOR, severe bony change, joint fluid, and bone marrow edema. Thus, combining various MRI variables may improve the diagnostic accuracy of TMJ pain.