Ultrasonographic findings in normal temporomandibular joints
The purpose of this study was to determine some ultrasonographic standards of temporomandibular joints with normally positioned discs. Nineteen patients from 18 to 45 years old (average age: 27.4 years; 16 females and 3 males), with history of orofacial pain, but without clinical or radiological sig...
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Published in: | Brazilian oral research Vol. 20; no. 1; pp. 25 - 32 |
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Abstract | The purpose of this study was to determine some ultrasonographic standards of temporomandibular joints with normally positioned discs. Nineteen patients from 18 to 45 years old (average age: 27.4 years; 16 females and 3 males), with history of orofacial pain, but without clinical or radiological signs of disc displacement, underwent ultrasonography (US) and magnetic resonance imaging (MRI) for the examination of their joints. In 30 joints, the distance between the most lateral point of the articular capsule and the most lateral point of the mandibular condyle (lateral capsule-condyle distance) was measured, as well as the distance between the most anterior point of the articular capsule and the most anterior point of the mandibular condyle (anterior capsule-condyle distance). In the closed-mouth position, the average values found for the lateral capsule-condyle distance were 1.4 mm and 1.6 mm, respectively in the longitudinal (coronal) and transverse (axial) scans. In the open-mouth position, the average distance was 1.2 mm, in both longitudinal (coronal) and transverse (axial) scans. The average values found for the anterior capsule-condyle distance were 2.3 mm in the closed-mouth position and 1.1 mm in the open-mouth position, both in transverse (axial) scans. Intra-examiner agreement, measured in terms of the intraclass correlation coefficient, varied from 0.83 to 0.93. We believe that this study can contribute to the validation of US as a diagnostic method for temporomandibular joint disorders, provided that the obtained measurements be used in future studies as normal reference values. |
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AbstractList | The purpose of this study was to determine some ultrasonographic standards of temporomandibular joints with normally positioned discs. Nineteen patients from 18 to 45 years old (average age: 27.4 years; 16 females and 3 males), with history of orofacial pain, but without clinical or radiological signs of disc displacement, underwent ultrasonography (US) and magnetic resonance imaging (MRI) for the examination of their joints. In 30 joints, the distance between the most lateral point of the articular capsule and the most lateral point of the mandibular condyle (lateral capsule-condyle distance) was measured, as well as the distance between the most anterior point of the articular capsule and the most anterior point of the mandibular condyle (anterior capsule-condyle distance). In the closed-mouth position, the average values found for the lateral capsule-condyle distance were 1.4 mm and 1.6 mm, respectively in the longitudinal (coronal) and transverse (axial) scans. In the open-mouth position, the average distance was 1.2 mm, in both longitudinal (coronal) and transverse (axial) scans. The average values found for the anterior capsule-condyle distance were 2.3 mm in the closed-mouth position and 1.1 mm in the open-mouth position, both in transverse (axial) scans. Intra-examiner agreement, measured in terms of the intraclass correlation coefficient, varied from 0.83 to 0.93. We believe that this study can contribute to the validation of US as a diagnostic method for temporomandibular joint disorders, provided that the obtained measurements be used in future studies as normal reference values.
Este estudo teve o objetivo de determinar alguns padrões ultra-sonográficos de articulações temporomandibulares com discos normalmente posicionados. Dezenove pacientes com 18 a 45 anos de idade (média de 27,4 anos, sendo 16 do sexo feminino e 3 do masculino), com queixa de dor orofacial, mas sem sinais clínicos ou radiológicos de deslocamento do disco, foram submetidos à ultra-sonografia (US) e à ressonância magnética (RM) para avaliação de suas articulações temporomandibulares (ATMs). Em 30 ATMs, mediu-se a distância entre o ponto mais lateral da cápsula articular e o ponto mais lateral do côndilo mandibular (distância cápsula lateral-côndilo), bem como a distância entre o ponto mais anterior da cápsula articular e o ponto mais anterior do côndilo mandibular (distância cápsula anterior-côndilo). Na posição de boca fechada, as médias das medidas da distância cápsula lateral-côndilo foram 1,4 mm e 1,6 mm, respectivamente nos cortes longitudinal (coronal) e transversal (axial). Na posição de boca aberta, a média foi 1,2 mm, em ambos os cortes. As médias das medidas da distância cápsula anterior-côndilo foram 2,3 mm na posição de boca fechada e 1,1 mm na posição de boca aberta, ambas nos corte transversais (axiais). A concordância intra-examinador, medida pelo coeficiente de correlação intraclasse, variou entre 0,83 e 0,93. Nós acreditamos que este estudo pode contribuir para a validação da US como uma técnica diagnóstica das disfunções temporomandibulares, à medida que as medidas obtidas sejam utilizadas em estudos futuros como valores normais de referência. The purpose of this study was to determine some ultrasonographic standards of temporomandibular joints with normally positioned discs. Nineteen patients from 18 to 45 years old (average age: 27.4 years; 16 females and 3 males), with history of orofacial pain, but without clinical or radiological signs of disc displacement, underwent ultrasonography (US) and magnetic resonance imaging (MRI) for the examination of their joints. In 30 joints, the distance between the most lateral point of the articular capsule and the most lateral point of the mandibular condyle (lateral capsule-condyle distance) was measured, as well as the distance between the most anterior point of the articular capsule and the most anterior point of the mandibular condyle (anterior capsule-condyle distance). In the closed-mouth position, the average values found for the lateral capsule-condyle distance were 1.4 mm and 1.6 mm, respectively in the longitudinal (coronal) and transverse (axial) scans. In the open-mouth position, the average distance was 1.2 mm, in both longitudinal (coronal) and transverse (axial) scans. The average values found for the anterior capsule-condyle distance were 2.3 mm in the closed-mouth position and 1.1 mm in the open-mouth position, both in transverse (axial) scans. Intra-examiner agreement, measured in terms of the intraclass correlation coefficient, varied from 0.83 to 0.93. We believe that this study can contribute to the validation of US as a diagnostic method for temporomandibular joint disorders, provided that the obtained measurements be used in future studies as normal reference values. |
Author | Elias, Fernando Melhem Matsuda, Cleide Kioco Jorge, Waldyr Antonio Birman, Esther Goldenberg Oliveira, Ilka Regina de Souza |
AuthorAffiliation | School of Dentistry University Hospital School of Medicine Universidade de São Paulo |
AuthorAffiliation_xml | – name: Universidade de São Paulo – name: School of Medicine – name: University Hospital – name: School of Dentistry |
Author_xml | – sequence: 1 givenname: Fernando Melhem surname: Elias fullname: Elias, Fernando Melhem organization: Division of Dentistry, University Hospital, University of São Paulo – sequence: 2 givenname: Esther Goldenberg surname: Birman fullname: Birman, Esther Goldenberg – sequence: 3 givenname: Cleide Kioco surname: Matsuda fullname: Matsuda, Cleide Kioco – sequence: 4 givenname: Ilka Regina de Souza surname: Oliveira fullname: Oliveira, Ilka Regina de Souza – sequence: 5 givenname: Waldyr Antonio surname: Jorge fullname: Jorge, Waldyr Antonio |
BackLink | https://www.ncbi.nlm.nih.gov/pubmed/16729171$$D View this record in MEDLINE/PubMed |
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Cites_doi | 10.2334/josnusd.40.89 10.1111/j.1365-2842.2004.01410.x 10.1054/jcms.2001.0252 10.1016/S1079-2104(97)90374-7 10.1016/S0889-5406(96)70148-8 10.2214/ajr.178.6.1781557 10.1053/joms.2002.33105 10.1067/moe.2002.121432 10.1016/S0278-2391(03)00247-7 10.1148/radiology.186.3.8430181 10.1067/moe.2002.126026 10.1053/joms.2002.36383 10.1016/j.ijom.2004.03.014 10.1046/j.1365-2842.2003.01063.x 10.1054/jcms.2000.0176 |
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Keywords | Ultrasonografia Temporomandibular joint disk Ultrasonography Transtornos da articulação temporomandibular Temporomandibular joint Temporomandibular joint disorders Articulação temporomandibular Disco da articulação temporomandibular |
Language | English |
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References | Katzberg RW (ref11) 1994 Motoyoshi M (ref13) 1998; 40 Landes C (ref12) 2000; 28 Brandlmaier I (ref1) 2003; 30 Emshoff R (ref3) 1997; 84 Tognini F (ref16) 2005; 32 Jank S (ref9) 2005; 34 Tasaki MM (ref15) 1996; 109 Uysal S (ref17) 2002; 94 Elias FM (ref2) 2002; 60 Emshoff R (ref7) 2002; 93 Emshoff R (ref4) 2003; 61 Jank S (ref10) 2001; 29 Emshoff R (ref5) 2002; 178 Emshoff R (ref6) 2002; 60 Tasaki MM (ref14) 1993; 186 Hayashi T (ref8) 2001; 22 Westesson PL (ref18) 2002; 60 Emshoff, R; Brandlmaier, I; Bodner, G; Rudisch, A 2003; 61 Katzberg, RW; Westesson, PL 1994 Elias, FM; Birman, EG; Jorge, WA; Homsi, C. 2002; 60 Jank, S; Emshoff, R; Norer, B; Missmann, M; Nicasi, A; Strobl, H 2005; 34 Jank, S; Rudisch, A; Bodner, G; Brandlmaier, I; Gerhard, S; Emshoff, R 2001; 29 Westesson, PL 2002; 60 Tasaki, MM; Westesson, PL 1993; 186 Emshoff, R; Jank, S; Rudisch, A; Walch, C; Bodner, G. 2002; 93 Emshoff, R; Jank, S; Rudisch, A; Bodner, G. 2002; 60 Motoyoshi, M; Kamijo, K; Numata, K; Namura, S 1998; 40 Uysal, S; Kansu, H; Akhan, O; Kansu, O 2002; 94 Hayashi, T; Ito, J; Koyama, J; Yamada, K 2001; 22 Landes, C; Walendzik, H; Klein, C 2000; 28 Emshoff, R; Bertram, S; Rudisch, A; Gabner, R 1997; 84 Brandlmaier, I; Rudisch, A; Bodner, G; Bertram, S; Emshoff, R. 2003; 30 Tasaki, MM; Westesson, PL; Isberg, AM; Ren, YF; Tallents, RH 1996; 109 Tognini, F; Manfredini, D; Melchiorre, D; Bosco, M 2005; 32 Emshoff, R; Jank, S; Bertram, S; Rudisch, A; Bodner, G 2002; 178 |
References_xml | – volume: 40 start-page: 89 issn: 1343-4934 issue: 2 year: 1998 ident: ref13 article-title: Ultrasonic imaging of the temporomandibular joint: a clinical trial for diagnosis of internal derangement publication-title: J Oral Sci doi: 10.2334/josnusd.40.89 contributor: fullname: Motoyoshi M – volume: 32 start-page: 248 issn: 0305-182X issue: 4 year: 2005 ident: ref16 article-title: Comparison of ultrasonography and magnetic resonance imaging in the evaluation of temporomandibular joint disc displacement publication-title: J Oral Rehabil doi: 10.1111/j.1365-2842.2004.01410.x contributor: fullname: Tognini F – volume: 29 start-page: 366 issn: 1010-5182 issue: 6 year: 2001 ident: ref10 article-title: High-resolution ultrasonography of the TMJ: helpful diagnostic approach for patients with TMJ disorders? publication-title: J Craniomaxillofac Surg doi: 10.1054/jcms.2001.0252 contributor: fullname: Jank S – volume: 84 start-page: 688 issn: 1079-2104 issue: 6 year: 1997 ident: ref3 article-title: The diagnostic value of ultrasonography to determine the temporomandibular joint disk position publication-title: Oral Surg Oral Med Oral Pathol Oral Radiol Endod doi: 10.1016/S1079-2104(97)90374-7 contributor: fullname: Emshoff R – volume: 60 start-page: 628 issn: 0278-2391 issue: 6 year: 2002 ident: ref18 article-title: Are high-resolution ultrasonographic signs of disc displacement valid? [discussion] publication-title: J Oral Maxillofac Surg contributor: fullname: Westesson PL – volume: 109 start-page: 249 issn: 0889-5406 issue: 3 year: 1996 ident: ref15 article-title: Classification and prevalence of temporomandibular joint disc displacement in patients and asymptomatic volunteers publication-title: Am J Orthod Dentofacial Orthop doi: 10.1016/S0889-5406(96)70148-8 contributor: fullname: Tasaki MM – volume: 178 start-page: 1557 issn: 0361-803X issue: 6 year: 2002 ident: ref5 article-title: Disk displacement of the temporomandibular joint: sonography versus MR imaging publication-title: AJR Am J Roentgenol doi: 10.2214/ajr.178.6.1781557 contributor: fullname: Emshoff R – volume: 60 start-page: 623 issn: 0278-2391 issue: 6 year: 2002 ident: ref6 article-title: Are high-resolution ultrasonographic signs of disc displacement valid? publication-title: J Oral Maxillofac Surg doi: 10.1053/joms.2002.33105 contributor: fullname: Emshoff R – volume: 93 start-page: 369 issn: 1079-2104 issue: 3 year: 2002 ident: ref7 article-title: Error patterns and observer variations in the high-resolution ultrasonography imaging evaluation of the disk position of the temporomandibular joint publication-title: Oral Surg Oral Med Oral Pathol Oral Radiol Endod doi: 10.1067/moe.2002.121432 contributor: fullname: Emshoff R – volume: 61 start-page: 877 issn: 0278-2391 issue: 8 year: 2003 ident: ref4 article-title: Condylar erosion and disc displacement: detection with high-resolution ultrasonography publication-title: J Oral Maxillofac Surg doi: 10.1016/S0278-2391(03)00247-7 contributor: fullname: Emshoff R – year: 1994 ident: ref11 contributor: fullname: Katzberg RW – volume: 186 start-page: 723 issn: 0033-8419 issue: 3 year: 1993 ident: ref14 article-title: Temporomandibular joint: diagnostic accuracy with sagittal and coronal MR imaging publication-title: Radiology doi: 10.1148/radiology.186.3.8430181 contributor: fullname: Tasaki MM – volume: 94 start-page: 115 issn: 1079-2104 issue: 1 year: 2002 ident: ref17 article-title: Comparison of ultrasonography with magnetic resonance imaging in the diagnosis of temporomandibular joint internal derangements: a preliminary investigation publication-title: Oral Surg Oral Med Oral Pathol Oral Radiol Endod doi: 10.1067/moe.2002.126026 contributor: fullname: Uysal S – volume: 22 start-page: 728 issn: 0195-6108 issue: 4 year: 2001 ident: ref8 article-title: The accuracy of sonography for evaluation of internal derangement of the temporomandibular joint in asymptomatic elementary school children: comparison with MR and CT publication-title: AJNR Am J Neuroradiol contributor: fullname: Hayashi T – volume: 60 start-page: 1381 issn: 0278-2391 issue: 11 year: 2002 ident: ref2 article-title: Ultrasonography of the temporomandibular joint: Where is the disc? [letter] publication-title: J Oral Maxillofac Surg doi: 10.1053/joms.2002.36383 contributor: fullname: Elias FM – volume: 34 start-page: 132 issn: 0901-5027 issue: 2 year: 2005 ident: ref9 article-title: Diagnostic quality of dynamic high-resolution ultrasonography of the TMJ: A pilot study publication-title: Int J Oral Maxillofac Surg doi: 10.1016/j.ijom.2004.03.014 contributor: fullname: Jank S – volume: 30 start-page: 796 issn: 0305-182X issue: 8 year: 2003 ident: ref1 article-title: Temporomandibular joint internal derangement: detection with 12. 5 MHz ultrasonography publication-title: J Oral Rehabil doi: 10.1046/j.1365-2842.2003.01063.x contributor: fullname: Brandlmaier I – volume: 28 start-page: 352 issn: 1010-5182 issue: 6 year: 2000 ident: ref12 article-title: Sonography of the temporomandibular joint from 60 examinations and comparison with MRI and axiography publication-title: J Craniomaxillofac Surg doi: 10.1054/jcms.2000.0176 contributor: fullname: Landes C – volume: 32 start-page: 248 issue: 4 year: 2005 end-page: 53 article-title: Comparison of ultrasonography and magnetic resonance imaging in the evaluation of temporomandibular joint disc displacement publication-title: J Oral Rehabil contributor: fullname: Tognini, F; Manfredini, D; Melchiorre, D; Bosco, M – volume: 30 start-page: 796 issue: 8 year: 2003 end-page: 801 article-title: Temporomandibular joint internal derangement: detection with 12. 5 MHz ultrasonography publication-title: J Oral Rehabil contributor: fullname: Brandlmaier, I; Rudisch, A; Bodner, G; Bertram, S; Emshoff, R. – volume: 28 start-page: 352 issue: 6 year: 2000 end-page: 61 article-title: Sonography of the temporomandibular joint from 60 examinations and comparison with MRI and axiography publication-title: J Craniomaxillofac Surg contributor: fullname: Landes, C; Walendzik, H; Klein, C – volume: 40 start-page: 89 issue: 2 year: 1998 end-page: 94 article-title: Ultrasonic imaging of the temporomandibular joint: a clinical trial for diagnosis of internal derangement publication-title: J Oral Sci contributor: fullname: Motoyoshi, M; Kamijo, K; Numata, K; Namura, S – volume: 93 start-page: 369 issue: 3 year: 2002 end-page: 75 article-title: Error patterns and observer variations in the high-resolution ultrasonography imaging evaluation of the disk position of the temporomandibular joint publication-title: Oral Surg Oral Med Oral Pathol Oral Radiol Endod contributor: fullname: Emshoff, R; Jank, S; Rudisch, A; Walch, C; Bodner, G. – volume: 60 start-page: 628 issue: 6 year: 2002 end-page: 9 article-title: Are high-resolution ultrasonographic signs of disc displacement valid? [discussion] publication-title: J Oral Maxillofac Surg contributor: fullname: Westesson, PL – volume: 84 start-page: 688 issue: 6 year: 1997 end-page: 96 article-title: The diagnostic value of ultrasonography to determine the temporomandibular joint disk position publication-title: Oral Surg Oral Med Oral Pathol Oral Radiol Endod contributor: fullname: Emshoff, R; Bertram, S; Rudisch, A; Gabner, R – year: 1994 publication-title: Diagnosis of the temporomandibular joint contributor: fullname: Katzberg, RW; Westesson, PL – volume: 61 start-page: 877 issue: 8 year: 2003 end-page: 81 article-title: Condylar erosion and disc displacement: detection with high-resolution ultrasonography publication-title: J Oral Maxillofac Surg contributor: fullname: Emshoff, R; Brandlmaier, I; Bodner, G; Rudisch, A – volume: 22 start-page: 728 issue: 4 year: 2001 end-page: 34 article-title: The accuracy of sonography for evaluation of internal derangement of the temporomandibular joint in asymptomatic elementary school children: comparison with MR and CT publication-title: AJNR Am J Neuroradiol contributor: fullname: Hayashi, T; Ito, J; Koyama, J; Yamada, K – volume: 29 start-page: 366 issue: 6 year: 2001 end-page: 71 article-title: High-resolution ultrasonography of the TMJ: helpful diagnostic approach for patients with TMJ disorders? publication-title: J Craniomaxillofac Surg contributor: fullname: Jank, S; Rudisch, A; Bodner, G; Brandlmaier, I; Gerhard, S; Emshoff, R – volume: 60 start-page: 1381 issue: 11 year: 2002 article-title: Ultrasonography of the temporomandibular joint: Where is the disc? [letter] publication-title: J Oral Maxillofac Surg contributor: fullname: Elias, FM; Birman, EG; Jorge, WA; Homsi, C. – volume: 186 start-page: 723 issue: 3 year: 1993 end-page: 9 article-title: Temporomandibular joint: diagnostic accuracy with sagittal and coronal MR imaging publication-title: Radiology contributor: fullname: Tasaki, MM; Westesson, PL – volume: 178 start-page: 1557 issue: 6 year: 2002 end-page: 62 article-title: Disk displacement of the temporomandibular joint: sonography versus MR imaging publication-title: AJR Am J Roentgenol contributor: fullname: Emshoff, R; Jank, S; Bertram, S; Rudisch, A; Bodner, G – volume: 60 start-page: 623 issue: 6 year: 2002 end-page: 8 article-title: Are high-resolution ultrasonographic signs of disc displacement valid? publication-title: J Oral Maxillofac Surg contributor: fullname: Emshoff, R; Jank, S; Rudisch, A; Bodner, G. – volume: 34 start-page: 132 issue: 2 year: 2005 end-page: 7 article-title: Diagnostic quality of dynamic high-resolution ultrasonography of the TMJ: A pilot study publication-title: Int J Oral Maxillofac Surg contributor: fullname: Jank, S; Emshoff, R; Norer, B; Missmann, M; Nicasi, A; Strobl, H – volume: 94 start-page: 115 issue: 1 year: 2002 end-page: 21 article-title: Comparison of ultrasonography with magnetic resonance imaging in the diagnosis of temporomandibular joint internal derangements: a preliminary investigation publication-title: Oral Surg Oral Med Oral Pathol Oral Radiol Endod contributor: fullname: Uysal, S; Kansu, H; Akhan, O; Kansu, O – volume: 109 start-page: 249 issue: 3 year: 1996 end-page: 62 article-title: Classification and prevalence of temporomandibular joint disc displacement in patients and asymptomatic volunteers publication-title: Am J Orthod Dentofacial Orthop contributor: fullname: Tasaki, MM; Westesson, PL; Isberg, AM; Ren, YF; Tallents, RH |
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SubjectTerms | Adolescent Adult Dentistry DENTISTRY, ORAL SURGERY & MEDICINE Female Humans Male Mandibular Condyle - diagnostic imaging Middle Aged Temporomandibular Joint - diagnostic imaging Temporomandibular Joint Disorders - diagnostic imaging Ultrasonography |
Title | Ultrasonographic findings in normal temporomandibular joints |
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