Diagnostic studies of Temporomandibular Joint Disorders in MRI and Arthroscopy-Correlation with Arthrography and surgical findings

在颞下颌关节紊乱病的诊断和治疗中，磁共振成像（MRI）是一种理想的方法，可以在短时间内显示颞下颌关节（TMJ）的硬、软组织结构。MRI对颞下颌关节盘紊乱，特别是盘前移位的检测和评估是有用的。由于MRI具有非放射性的诊断能力，对单纯性颞下颌关节内紊乱病的诊断具有上级价值，关节造影技术对颞下颌关节内紊乱病的诊断具有重要意义。下关节间隙的单对比度关节造影使得能够容易且简单地检测关节盘的大致位置和动力学。传统关节造影被认为是发现关节内粘连或穿孔的重要方法，关节镜检查对TMJ闭锁的患者进行。通过阿尔斯可清楚地发现囊内病变 ...更多信息 本文对MRI证实的闭合性颞下颌关节内紊乱病的保守治疗效果进行了研究。保守治疗逐步应用如下：1。口服抗炎药和肌松药，2.下颌手法或泵压手法; 3.夹板疗法结果显示，保守治疗成功率约为60%。根据1986年日本TMJ学会提出的TMJ关节病分类，将TMJ关节病患者分为5型。在我们的诊所中的型分布如下，III型最常见，约45%，其次是II型、IV型、Type 1和Type V。大多数1 IV型是女性。颞下颌关节骨改变不明显且关节盘移位的病例不能明确确定为III型或IV型。Ⅱ型因其疼痛特征为唯一决定因素而最难判断，对于复杂型，其诊断标准及应用有待进一步研究。少

In diagnosis and therapy of temporomandibular joint disorders magnetic resonance imaging(MRI)in an ideal method for visualizing hard and soft tissue structures of the temporomandibular joint(TMJ)in a short examination. MRI is useful for detection and evaluation of TMJ disk derangements, particularly in disk anterior displacement. Because of its non-irradiative diagnostics capacity, MRI has a superior value for diagnosis of uncomplicated internal derangement of the TMJ.Arthrographic technique has been very significant on diagnosis for internal derangement of TMJ. The single contrast arthrography of the lower joint space made it possible to easily and simply detect approximate position and dynamics of the joint disk. Conventional arthrography was thought as an important procedure to detect a finding of intra-articular adhesion or perforation.Arthroscopic examination was performed on the patients with closed lock of the TMJ. The intracapsular pathosis was clearly detected through the arth … More roscopy, and which enabled significant progress in diagnosis and treatment for closed lock TMJ patients.The effectivity of conservative therapy for internal derangemente with closed rock of the TMJ, confirmed in MRI were investigated. Conservative therapy was gradually applied as follows : 1. oral medication of anti-inflammatory drug and muscle relaxant, 2. mandibular manipulation or pumping manipulation technique, 3. splint therapy. In the results, about 60% were successfully unlocked by the conservative therapy.The patients with TMJ arthrosis were evaluated classified 5 types based on a classification proposed by the Japanese Society of TMJ in 1986. The iype distribution in our clinic was as follows, Type III was most commonly encountered about 45% followed by Type II Type IV, Typel and TypeV. The majority of Type 1IV were females. The cases of which bone changes of the TMJ are not so remarkable and the disks are displaced, could not be clearly determined as either Type III or Type IV. The judgment of Type II was most difficult because of its pain characters being the sole determinant.In regard to complex type, it needs further study to determine its diagnostic criteria and application. Less