The relationship between clinical and MRI findings in patients with unilateral temporomandibular joint pain
The relationship between clinical and MRI findings in patients with unilateral temporomandibular joint pain
复制标题
DOI：
10.14219/jada.archive.2001.0210
复制
发表时间：
2001-04-01
影响因子：
3.9
通讯作者：
Andreasen, K
中科院分区：
文献类型：
--
作者：
Haley, DP;Schiffman, EL;Andreasen, K
背景。随着磁共振成像技术（MRI）的出现，临床医生和研究人员有了复杂的技术来评估颞下颌关节（TMJ）的解剖结构。当检查结果对患者护理的影响超过完整的临床评估时，需要进行影像学检查。颞下颌疾病（TMDs）患者治疗的主要适应症之一是颌骨疼痛，包括颞下颌关节疼痛。因此，有必要评估mri描述的TMJ表现是否与TMJ疼痛相关。本研究评估了颞下颌关节疼痛与临床和MRI表现的关系。研究对象包括85例颞下颌关节区域单侧下颌疼痛的患者。对侧无疼痛的颞下颌关节作为对照。所有患者都进行了完整的口腔检查，包括触诊两个颞下颌关节。在一周内获得双侧核磁共振成像之前，没有给予护理，也没有开消炎药。作者发现，报告的下颌疼痛一侧与患者报告的颞下颌关节触诊疼痛之间存在显著的关系，以及报告的疼痛一侧与mri检测到的积液之间存在显著的关系。作者发现疼痛的一侧与椎间盘移位或DD的存在没有关系，也没有发现颌骨两侧积液和DD的存在之间的关系。尽管mri描述的TMJ积液与TMJ疼痛的报告有关，但假阳性和假阴性的发生率很高。结果表明，对于单侧颌骨疼痛的患者，触诊TMJ比mri描述的积液更准确地确定TMJ是疼痛的来源。临床意义。本研究的结果表明，触诊颞下颌关节优于MRI识别关节疼痛的来源。因此，确定TMJ是否是颌骨疼痛来源的最昂贵、最有效的测试是完整的临床评估。
Background. With the advent of magnetic resonance imaging, or MRI, clinicians and researchers have sophisticated techniques by which to assess the anatomy of the temporomandibular joint, or TMJ. Imaging is indicated when the results will affect the patients care beyond that which can be gained from a complete clinical assessment. One of the primary indications for treatment of patients with temporomandibular disorders or TMDs, is jaw pain, includingTMJ pain. Therefore, it is necessary to:assess whether MRI-depicted TMJ findings are associated with TMJ pain. This study assessed the relationship between TMJ pain and clinical and MRI findings.Methods. Subjects consisted of 85 patients with unilateral jaw pain in the area of the TJM. The:contralateral, nonpainful TMJ served as the matched control. ALL patients underwent a complete stomatagnathic examination that included palpation of both TMJs. No care was given and no anti-inflammatory medications were prescribed until bilateral MRIs were obtained within one weekResults. The authors found significant, relationships between the side of reported jaw pain and the patient's report that palpation of the TMJ was painful and between the side of reported pain and the presence of MRI-detected effusions. The authors found no relationship between the side of reported 1 pain and the presence of a disk displacement or DD, or between the presence of effusions and DD on either side of the jaw.Conclusion. Although MRI-depicted effusions of the TMJ were associated with reports of the TMJ pain, there was a high level of false positive and false-negative findings. The results indicate that palpation of the TMJ TMJ is more accurate than MRI-depicted effusions in identifying the TMJ as the source of pain for patients with unilateral jaw pain. Clinical Implications. The results of this study suggest that palpation of the TMJ is superior to MRI in identifying the joint as the source of pain. Therefore, the most costly effective and valid test to determine if the TMJ is a source of jaw pain is a complete clinical assessment.