Results of radiological follow-up of untreated anterior disc displacement without reduction in adolescents

Abstract

Our aim was to assess the progression of disease without treatment in adolescents with non-reducible anterior disc displacement (ADD) using serial magnetic resonance images (MRI). We retrospectively reviewed all patients under the age of 20 years who had unilateral non-reducible ADD and had had two MRI during a period of 6 months with no intervention. A total of 124 patients (101 female and 23 male) with a mean (range) age of 16 (10-20) years had 2 MRI at least 6 months apart (mean (range) 14 (6-47) months). At the initial visit there was a significant difference between the involved and the non-involved sides in the incidence of condylar degeneration and effusion (p=0.0001). The effusion significantly decreased despite the lack of intervention, the amount of disc deformation significantly increased (p=0.003), and the degree of condylar degeneration increased from 61%-69%, but this did not differ significantly. We conclude that during the period of observation there was a significant reduction in the incidence of effusion and significant increase in disc deformation. Whilst there was an increase in the changes on the condylar surface, this was not significant.