Critical points in MRI examination of patients with anterior disc displacement

Abstract

Objectives: The aim of this study is to de- termine the importance of the distance of tubercle head displacement when using MRI to investigate an- terior disc displacement of the CSF disc and to study when and under what conditions the term repositioning should be applied Material and method: MRI images of anterior disc mis- alignment are presented, where an attempt is made to staging the misalignment and articular disc reset. The statistical sample was patients with symptoms of pain and TMJ dysfunction, in whom anterior misalign- ment was diagnosed clinically and confirmed by MRI ex- amination in the closed mouth position. Results: The distance travelled by the tubercle head within the joint is influenced by the acquisition technique and this is crucial for the diagnosis Conclusions: The importance of condylar head move- ment is great in the study of temporomandibular joint dysfunctions and should always be evaluated in con- junction with the position of the articular disc and its morphology. When ‘reversion’ is recorded as any case where the tu- bercle head in a position of maximum opening meets the disc, regardless of the distance from the articular germ, what is interpreted as a reversion conceals the extent of the joint pathology, because it is not a restora- tion of the normal disc-condyle-physeal relationship, but a situation that is detrimental to the morphology of the disc and an intermittent opening with obstacles. Hypermobility and hypermobility often coexist with anterior disc misalignment, evading diagnosis even with MRI imaging due to the application of the passive-open- ing technique. Static imaging with active opening is currently the method of choice that provides the necessary information both for the range of tuberosity movement and for the study of disc and posterior tissue morphology.