Temporomandibular Disorders: MR Assessment of Inflammatory Changes in the Posterior Disk Attachment During the Menstrual Cycle

Abstract

Our goal was to correlate the menstrual cycle with joint pain, MR evidence of the disk, and posterior disk attachment in patients with temporomandibular disorders. Forty-two women underwent MRI involving conventional T1-and T2-weighted gadolinium-enhanced fat-suppressed SE imaging sequences. There was a strong statistical difference in the degree of joint pain between proliferated phase and secretory phase groups (p < 0.005). Joint pain had a tendency to increase at the secretory phase. Significantly less contrast enhancement of the posterior disk attachment was observed in the proliferated phase than in the secretory phase (p < 0.001) or menstrual phase (p < 0.01). In addition, anterior disk displacement without reduction of the temporomandibular joint was closely associated with joint pain. Our results suggest that positional changes of the disk and the menstrual cycle may play a role in the degree of joint pain and inflammatory pathology of the posterior disk attachment.