Johnston Katie, Bird Lance, Bright Phillip
European School of Osteopathy, University of Greenwich, Maidstone, Kent, UK.
Ultrasound. 2015 May;23(2):90-6. doi: 10.1177/1742271X14568608. Epub 2015 Feb 5.
The relationship between effusion of the temporomandibular joint (TMJ) and patient-reported disability is poorly researched. This pilot study explored the link between TMJ inflammation as measured by ultrasound and patient disability assessed by the Steigerwald Maher TMD Disability Index (SMTDI). The study design used a prospective correlational approach involving a sample with TMJ dysfunction (TMD). Twenty-four patients were recruited from the European School of Osteopathy and a Kent dental practice. Participants completed the SMTDI to determine the level of TMD (symptomatic score >20). A SonoSite SLA "Hockey Stick" [13-6 MHz] musculo-skeletal transducer was placed over the TMJ in a transverse direction and effusion was calculated indirectly by measuring capsular width. An upper left quadrant protocol was used throughout. A regression analysis was run with participants' gender, age and capsular width as predictor variables modelled against reported SMTDI. Larger capsular widths were found to be significant predictors of SMTDI scores (r = 0.803, p < 0.0001). The patient profile matched with the previous studies and the TMD sufferer population, indicating external validity. Results suggest that the SMTDI could be integrated into practice life as a quick, accessible and easy tool to monitor patients' progress and assess levels of inflammation, without the need for repetitive imaging. The study design proved reproducible and a larger scale study is indicated.
颞下颌关节(TMJ)积液与患者报告的功能障碍之间的关系研究较少。这项初步研究探讨了通过超声测量的TMJ炎症与通过施泰格瓦尔德·马赫颞下颌关节紊乱症残疾指数(SMTDI)评估的患者残疾之间的联系。该研究设计采用前瞻性相关方法,涉及一个患有TMJ功能障碍(TMD)的样本。从欧洲整骨疗法学院和肯特郡的一家牙科诊所招募了24名患者。参与者完成SMTDI以确定TMD的水平(症状评分>20)。将一台SonoSite SLA“曲棍球棒”[13 - 6MHz]肌肉骨骼换能器横向放置在TMJ上,并通过测量关节囊宽度间接计算积液量。整个过程采用左上象限方案。以参与者的性别、年龄和关节囊宽度作为预测变量,针对报告的SMTDI进行回归分析。发现较大的关节囊宽度是SMTDI评分的显著预测因素(r = 0.803,p < 0.0001)。患者特征与先前的研究和TMD患者群体相匹配,表明具有外部效度。结果表明,SMTDI可以作为一种快速、便捷且易于使用的工具融入临床实践,用于监测患者的进展并评估炎症水平,而无需重复进行影像学检查。该研究设计证明具有可重复性,表明需要进行更大规模的研究。