Yamamoto Mika, Sano Tsukasa, Okano Tomohiro
Department of Radiology, Showa University School of Dentistry, Tokyo, Japan.
J Comput Assist Tomogr. 2003 Sep-Oct;27(5):694-8. doi: 10.1097/00004728-200309000-00006.
The relationship between temporomandibular joint (TMJ) effusion and TMJ disorders is controversial. The frequency of TMJ effusion has varied as shown in previous studies. Furthermore, though some authors have suggested a correlation between TMJ effusion and pain, others question the relationship. In order to clarify the relationship, it is necessary to quantify the degree of effusion and thoroughly investigate its relationship to other factors. The purpose of this study was to analyze the amount of TMJ fluid present in joints with TMJ disorders and to see how TMJ effusion is related to TMJ status and pain.
We studied 577 joints in 293 patients referred to us for magnetic resonance imaging. The joints were divided into painful and nonpainful categories and also classified according to Westesson's criteria for the status of the TMJ. The grading system of Larheim et al was used for categorizing the amount of fluid. Statistical methods were used for analyzing the relationship between TMJ fluid and TMJ status and pain.
TMJs with disk displacement without reduction showed the largest amount of fluid while TMJs with normal superior disk position showed the least fluid (Kruskal-Wallis test, P<0.001; Scheffe test, P<0.001). There was a significant difference in the amount of the fluid between painful and nonpainful joints in the group of disk displacement without reduction (Wilcoxon rank sum test, P<0.001). No significant differences were found between other groups.
Joint effusion is likely to appear in painful TMJs with disk displacement without reduction. Joint effusion may be an abnormal entity just suited to joints with disk displacement without reduction.
颞下颌关节（TMJ）积液与颞下颌关节紊乱病之间的关系存在争议。如先前研究所显示，TMJ积液的发生率各不相同。此外，尽管一些作者认为TMJ积液与疼痛之间存在关联，但另一些人对这种关系提出质疑。为了阐明这种关系，有必要对积液程度进行量化，并深入研究其与其他因素的关系。本研究的目的是分析患有颞下颌关节紊乱病的关节中TMJ液的量，并观察TMJ积液与TMJ状态和疼痛之间的关系。
我们研究了293例因磁共振成像前来就诊的患者的577个关节。将这些关节分为疼痛组和非疼痛组，并根据韦斯特森（Westesson）的颞下颌关节状态标准进行分类。采用拉尔海姆（Larheim）等人的分级系统对积液量进行分类。使用统计方法分析TMJ液与TMJ状态和疼痛之间的关系。
盘移位不可复的TMJ积液量最大，而上盘位置正常的TMJ积液量最少（Kruskal-Wallis检验，P<0.001；Scheffe检验，P<0.001）。在盘移位不可复组中，疼痛关节和非疼痛关节的积液量存在显著差异（Wilcoxon秩和检验，P<0.001）。其他组之间未发现显著差异。
关节积液可能出现在盘移位不可复的疼痛性TMJ中。关节积液可能是一种仅适用于盘移位不可复关节的异常情况。
