Abstract
BackgroundTo determine whether capsular distention in the painful temporomandibular joint (TMJ) can be assessed by ultrasonography, we compared the capsular width between painful TMJs and painless TMJ. The risk factors for TMJ pain were also investigated including capsular width and other clinical factors such as TMJ sounds that may affect the occurrence and persistence of TMJ pain.MethodsTMJ ultrasonography was performed on 87 temporomandibular disorder (TMD) patients, including 47 unilateral and 29 bilateral TMJ pain patients, and 11 patients without TMJ pain.ResultsThe capsular width was greater in the 105 painful joints than in the 69 painless joints. Considering individual anatomical variations, the differences between painful and painless joints in unilateral TMJ pain patients were also analyzed, revealing a greater width in painful joints. Capsular width was a risk factor for TMJ pain with an adjusted odds ratio of 1.496 (95% confidence interval 1.312–1.706; p < 0.001) and was significantly correlated with pain scores.ConclusionThis correlation may suggest that pain intensity is associated with widened capsular width because of joint effusion or synovitis. Further studies are required to refine and establish the protocols for standard examinations using ultrasound imaging.
Highlights
To determine whether capsular distention in the painful temporomandibular joint (TMJ) can be assessed by ultrasonography, we compared the capsular width between painful TMJs and painless TMJ
We found that only capsular width was an independent risk factor for TMJ pain
Using receiver operating characteristic (ROC) curve analysis to assess the cutoff value for capsular width that could be used to discriminate among joints with and without an magnetic resonance imaging (MRI) diagnosis of effusion, they demonstrated that the cutoff value was around 2 mm
Summary
To determine whether capsular distention in the painful temporomandibular joint (TMJ) can be assessed by ultrasonography, we compared the capsular width between painful TMJs and painless TMJ. Because of the limitation of imaging modalities of the TMJ, there has been a need for an alternative diagnostic tool for the clinical evaluation of TMD. Ultrasonography is a non-invasive, pain-free, economical, and real-time diagnostic modality that can be used in an outpatient setting. It has certain drawbacks, such as its limited access to deep structures or to articular discs owing to the absorption of the sound waves by the mandibular and temporal bones, as a result of which images of the internal tissue cannot be properly formed. Koski et al evaluated the capsular width of the hip joints in patients with chronic inflammatory disease using ultrasonography. Friedman et al reported that ultrasonography of the knee can be applied clinically to assess knee tendons, muscles, and ligaments, as well as joint effusions and synovial thickening [5]
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