Cholitgul W, Nishiyama H, Sasai T, Uchiyama Y, Fuchihata H, Rohlin M
Department of Radiology, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand.
Dentomaxillofac Radiol. 1997 May;26(3):183-8. doi: 10.1038/sj.dmfr.4600239.
To describe the clinical and MRI findings in patients with disc displacement of the temporomandibular joint.
Eighty-eight joints in 51 patients referred for suspected TMJ disc displacement were examined by MRI. Two oral radiologists assessed the images. The clinical findings were obtained by retrospective review of the patients' records.
Clicking was the most common clinical finding, present in 47 joints. Pain was reported for only 30 joints. Anterior disc displacement with reduction was found in 39 joints, anterior disc displacement without reduction in 31 joints, compound dislocations (anterolateral or anteromedial) in 13 joints and sideways displacement in 5 joints respectively. In about one-fourth of the joints, MRI revealed abnormal configuration of both disc and condyle. The osseous changes were subtle. Only 9% of the joints exhibited an osteophyte. Joint effusion in either the upper or the lower joint compartment was found in 19 joints. Out of 14 patients with joint effusion, six patients complained of pain from the TMJ region.
The most extensive soft and hard tissue changes were found in patients with anterior disc displacement without reduction. Pain was not a characteristic symptom for any type of disc displacement.
描述颞下颌关节盘移位患者的临床及MRI表现。
对51例因疑似颞下颌关节盘移位而转诊的患者的88个关节进行了MRI检查。两名口腔放射科医生对图像进行了评估。通过回顾患者记录获得临床发现。
弹响是最常见的临床发现，47个关节存在弹响。仅30个关节报告有疼痛。分别在39个关节中发现可复性盘前移位，31个关节中发现不可复性盘前移位，13个关节中发现复合性脱位（前外侧或前内侧），5个关节中发现侧向移位。在约四分之一的关节中，MRI显示盘和髁突均有异常形态。骨质改变不明显。仅9%的关节有骨赘。19个关节在上关节腔或下关节腔有积液。在14例有关节积液的患者中，6例患者主诉颞下颌关节区域疼痛。
在不可复性盘前移位患者中发现了最广泛的软硬组织改变。疼痛并非任何类型盘移位的特征性症状。
