Miller T L, Katzberg R W, Tallents R H, Bessette R W, Hayakawa K
Radiology. 1985 Jan;154(1):121-4. doi: 10.1148/radiology.154.1.3964930.
Patients who have temporomandibular joint (TMJ) clicking and pain are assumed to have an anterior displacement of the meniscus with reduction on opening of the jaw. On the basis of this assumption, these patients are treated nonsurgically with splint therapy. Of 301 TMJs examined, 108 (36%) produced clinically audible clicks on opening, closing, or both. Fluoroscopy and arthrotomography studies for 16 (15%) showed anteriorly displaced menisci without reduction. The mean age of this group was 32 years, with a range of 17-51 years. The duration of the patients' symptoms ranged from three months to eight years (mean 3.7 years). Bilateral degenerative joint disease was noted in 8/16 (50%). Operative findings in four patients suggested the cause of the clicking sound as a frictional impact between the degenerated surface of the condyle and the hypertrophied displaced meniscus. These observations demonstrate that an audible click may not imply a reduction of a displaced meniscus.
患有颞下颌关节（TMJ）弹响和疼痛的患者被假定为半月板向前移位，在张口时可复位。基于这一假设，这些患者接受夹板治疗而非手术治疗。在接受检查的301个颞下颌关节中，108个（36%）在张口、闭口或两者时产生临床上可听到的弹响。16个（15%）的荧光镜检查和关节断层摄影研究显示半月板向前移位且未复位。该组患者的平均年龄为32岁，范围为17至51岁。患者症状持续时间为3个月至8年（平均3.7年）。16例中有8例（50%）发现双侧退行性关节病。4例患者的手术结果表明，弹响的原因是髁突退变表面与肥大的移位半月板之间的摩擦撞击。这些观察结果表明，可听到的弹响可能并不意味着移位半月板的复位。
