Skip to main content

Advertisement

SpringerLink
Log in

Assessment of articular disc displacement of temporomandibular joint with ultrasound

  • Original Article
  • Published:
Journal of Ultrasound Aims and scope Submit manuscript

Abstract

Purpose

To assess pattern of articular disc displacement in patients with internal derangement (ID) of temporomandibular joint (TMJ) with ultrasound.

Materials and methods

Prospective study was conducted upon 40 TMJ of 20 patients (3 male, 17 female with mean age of 26.1 years) with ID of TMJ. They underwent high-resolution ultrasound and MR imaging of TMJ. The MR images were used as the gold standard for calculating sensitivity, specificity, accuracy, positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (PLR), and negative likelihood ratio (NLR) of ultrasound for diagnosis of anterior or sideway displacement of the disc.

Results

The anterior displaced disc was seen in 26 joints at MR and 22 joints at ultrasound. The diagnostic efficacy of ultrasound for anterior displacement has sensitivity of 79.3 %, specificity of 72.7 %, accuracy of 77.5 %, PPV of 88.5 %, NPV of 57.1 %, PLR of 2.9 and NLR of 0.34. The sideway displacement of disc was seen in four joints at MR and three joints at ultrasound. The diagnostic efficacy of ultrasound for sideway displacement has a sensitivity of 75 %, specificity of 63.6 %, accuracy of 66.7 %, PPV of 42.8, NPV of 87.5 %, PLR of 2.06, and NLR of 0.39.

Conclusion

We concluded that ultrasound is a non-invasive imaging modality used for assessment of anterior and sideway displacement of the articular disc in patients with ID of TMJ.

Riassunto

Scopo

Valutare i pattern della dislocazione del disco articolare nei pazienti con squilibrio interno (ID) dell’articolazione temporo-mandibolare (ATM) con l’ecografia.

Materiale e metodi

E’ stato condotto uno studio prospettico su 40 ATM di 20 pazienti (3 maschi, 17 femmine, con età media di 26,1 anni) con ID della TMJ. Tutti sono stati sottoposti ad ecografia ad alta risoluzione e RM della TMJ. La RM è stati utilizzata come il gold standard per il calcolo di sensibilità, specificità, accuratezza, valore predittivo positivo (PPV), valore predittivo negativo (NPV), rapporto di probabilità positivo (PLR) e rapporto di probabilità negativo (NLR) dell’ecografia nella la diagnosi di dislocazione anteriore o lateralmente del disco.

Risultati

Il disco appariva dislocato anteriormente in 26 ATM con la MR e in 22 con l’ecografia. L’efficacia diagnostica dell’ecografia nella diagnosi di dislocazione anteriore aveva sensibilità del 79,3 %, specificità del 72,7 %, accuratezza del 77,5 %, valore predittivo positivo del 88,5 %, NPV di 57,1 %, PLR di 2,9 e NLR di 0,34. Il dislocamento laterale del disco è stata osservato in 4 casi con MR e 3 con ecografia. L’efficacia diagnostica dell’ecografia per lo spostamento laterale aveva sensibilità del 75 %, specificità del 63,6 %, accuratezza del 66,7 %, PPV di 42,8, NPV di 87,5 %, PLR di 2.06 e NLR di 0,39.

Conclusioni

Abbiamo concluso che l’ecografia è una metodica di imaging non invasiva che può essere utilizzata per la valutazione delle dislocazioni anteriori e laterali del disco articolare nei pazienti con ID di TMJ.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Hunter A, Kalathingal S (2013) Diagnostic imaging for temporomandibular disorders and orofacial pain. Dent Clin N Am 57:405–418

    Article  PubMed  Google Scholar 

  2. de Leeuw R (2008) Internal Derangements of the temporomandibular joint. Oral Maxillofac Surg Clin N Am 20:159–168

    Article  Google Scholar 

  3. Vilanova J, Barceló J, Puig J, Remollo S, Nicolau C, Bru C (2007) Diagnostic imaging: magnetic resonance imaging, computed tomography, and ultrasound. Semin Ultrasound CT MRI 28:184–191

    Article  Google Scholar 

  4. Aiken A, Bouloux G, Hudgins P (2012) MR imaging of the temporomandibular joint. Magn Reson Imaging Clin N Am 20:397–412

    Article  PubMed  Google Scholar 

  5. Rao VM, Liem M, Farole A, Razek AA (1993) Elusive “stuck” disk in the temporomandibular joint: diagnosis with MR imaging. Radiology 189:823–827

    Article  CAS  PubMed  Google Scholar 

  6. Whyte AM, McNamara D, Rosenberg I, Whyte AW (2006) Magnetic resonance imaging in the evaluation of temporomandibular joint disc displacement—a review of 144 cases. Int J Oral Maxillofac Surg 35:696–703

    Article  CAS  PubMed  Google Scholar 

  7. Eberhard L, Giannakopoulos NN, Rohde S, Schmitter M (2013) Temporomandibular joint (TMJ) disc position in patients with TMJ pain assessed by coronal MRI. Dentomaxillofac Radiol 42:20120199

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  8. Kirk WS Jr (2013) Lateral impingements of the temporomandibular joint: a classification system and MRI imaging characteristics. Int J Oral Maxillofac Surg 42:223–228

    Article  PubMed  Google Scholar 

  9. Schmitter M, Kress B, Ludwig C, Koob A, Gabbert O, Rammelsberg P (2005) Temporomandibular joint disk position assessed at coronal MR imaging in asymptomatic volunteers. Radiology 236:559–564

    Article  PubMed  Google Scholar 

  10. Chen YJ, Gallo LM, Meier D, Palla S (2000) Individualized oblique-axial magnetic resonance imaging for improved visualization of mediolateral TMJ disc displacement. J Orofac Pain 14:128–139

    CAS  PubMed  Google Scholar 

  11. Razek AA, Fouda NS, Elmetwaley N, Elbogdady E (2009) Sonography of the knee joint. J Ultrasound 12:53–60

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  12. Sakellariou G, Iagnocco A, Filippucci E, Ceccarelli F, Di Geso L, Carli L et al (2013) Ultrasound imaging for the rheumatologist XLVIII. Ultrasound of the shoulders of patients with rheumatoid arthritis. Clin Exp Rheumatol 31:837–842

    PubMed  Google Scholar 

  13. Abdel Razek A, Fouda N, Elmetwaly N, Elbogdady E (2008) Sonography of the knee joint–technique and normal anatomy. Eur Med Imaging Rev 1:66–68

    Google Scholar 

  14. Li C, Su N, Yang X, Yang X, Shi Z, Li L (2012) Ultrasonography for detection of disc displacement of temporomandibular joint: a systematic review and meta-analysis. J Oral Maxillofac Surg 70:1300–1309

    Article  PubMed  Google Scholar 

  15. Manfredini D (2012) Ultrasonography has an acceptable diagnostic efficacy for temporomandibular disc displacement. Evid Based Dent 13:84–85

    Article  PubMed  Google Scholar 

  16. Dupuy-Bonafé I, Picot MC, Maldonado IL, Lachiche V, Granier I, Bonafé A (2012) Internal derangement of the temporomandibular joint: is there still a place for ultrasound? Oral Surg Oral Med Oral Pathol Oral Radiol 113:832–840

    Article  PubMed  Google Scholar 

  17. Manfredini D, Guarda-Nardini L (2009) Ultrasonography of the temporomandibular joint: a literature review. Int J Oral Maxillofac Surg 38:1229–1236

    Article  CAS  PubMed  Google Scholar 

  18. Melis M, Secci S, Ceneviz C (2007) Use of ultrasonography for the diagnosis of temporomandibular joint disorders: a review. Am J Dent 20:73–78

    PubMed  Google Scholar 

  19. Bas B, Yılmaz N, Gökce E, Akan H (2011) Diagnostic value of ultrasonography in temporomandibular disorders. J Oral Maxillofac Surg 69:1304–1310

    Article  PubMed  Google Scholar 

  20. Cakir-Ozkan N, Sarikaya B, Erkorkmaz U, Aktürk Y (2010) Ultrasonographic evaluation of disc displacement of the temporomandibular joint compared with magnetic resonance imaging. J Oral Maxillofac Surg 68:1075–1080

    Article  PubMed  Google Scholar 

  21. Kaya K, Dulgeroglu D, Unsal-Delialioglu S, Babadag M, Tacal T, Barlak A et al (2010) Diagnostic value of ultrasonography in the evaluation of the temporomandibular joint anterior disc displacement. J Craniomaxillofac Surg 38:391–395

    Article  PubMed  Google Scholar 

  22. Byahatti SM, Ramamurthy BR, Mubeen M, Agnihothri PG (2010) Assessment of diagnostic accuracy of high-resolution ultrasonography in determination of temporomandibular joint internal derangement. Indian J Dent Res 21:189–194

    Article  PubMed  Google Scholar 

  23. Landes C, Sader R (2007) Sonographic evaluation of the ranges of condylar translation and of temporomandibular joint space as well as first comparison with symptomatic joints. J Craniomaxillofac Surg 35:374–381

    Article  PubMed  Google Scholar 

  24. Rudisch A, Emshoff R, Maurer H, Kovacs P, Bodner G (2006) Pathologic–sonographic correlation in temporomandibular joint pathology. Eur Radiol 16:1750–1756

    Article  PubMed  Google Scholar 

  25. Jank S, Emshoff R, Norer B, Missmann M, Nicasi A, Strobl H et al (2005) Diagnostic quality of dynamic high-resolution ultrasonography of the TMJ—a pilot study. Int J Oral Maxillofac Surg 34:132–137

    Article  CAS  PubMed  Google Scholar 

  26. Emshoff R, Jank S, Bertram S, Rudisch A, Bodner G (2002) Disk displacement of the temporomandibular joint: sonography versus MR imaging. AJR Am J Roentgenol 178:1557–1562

    Article  PubMed  Google Scholar 

  27. Uysal S, Kansu H, Akhan O, Kansu O (2002) Comparison of ultrasonography with magnetic resonance imaging in the diagnosis of temporomandibular joint internal derangements: a preliminary investigation. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 94:115–121

    Article  PubMed  Google Scholar 

  28. Emshoff R, Jank S, Rudisch A, Walch C, Bodner G (2002) Error patterns and observer variations in the high-resolution ultrasonography imaging evaluation of the disk position of the temporomandibular joint. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 93:369–375

    Article  PubMed  Google Scholar 

  29. Truelove EL, Sommers EE, LcResch L, Dworkin SF, Von Korff M (1992) Clinical diagnostic criteria for TMD: new classification permits multiple diagnoses. J Am Dent Assoc 123:47

    Article  CAS  PubMed  Google Scholar 

  30. Ahmad M, Hollender L, Anderson Q, Kartha K, Ohrbach R, Truelove EL et al (2009) Research diagnostic criteria for temporomandibular disorders (RDC/TMD): development of image analysis criteria and examiner reliability for image analysis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 107:844–860

    Article  PubMed Central  PubMed  Google Scholar 

  31. Landes CA, Goral WA, Sader R, Mack MG (2007) Three-dimensional versus two-dimensional sonography of the temporomandibular joint in comparison to MRI. Eur J Radiol 61:235–244

    Article  PubMed  Google Scholar 

Download references

Conflict of interest

The authors (Abdel Razek A, Al Belasy F, Ahmed W, Haggag M) have no conflict of interest.

Informed consent

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000 (5). All patients provided written informed consent to enrolment in the study and to the inclusion in this article of information that could potentially lead to their identification.

Human and animal studies

The study conducted in accordance with all institutional and national guidelines for the care and use of laboratory animals.

Author information

Authors and Affiliations

  1. Department of Diagnostic Radiology, Mansoura Faculty of Medicine, Mansoura, 13351, Egypt

    Ahmed Abdel Khalek Abdel Razek

  2. Department of Oral and Maxillofacial Surgery, Mansoura Faculty of Dentistry, Mansoura, Egypt

    Fouad Al Mahdy Al Belasy, Wael Mohamed Said Ahmed & Mai Ahmed Haggag

Authors
  1. Ahmed Abdel Khalek Abdel Razek
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Fouad Al Mahdy Al Belasy
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Wael Mohamed Said Ahmed
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Mai Ahmed Haggag
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ahmed Abdel Khalek Abdel Razek.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Razek, A.A.K.A., Al Mahdy Al Belasy, F., Ahmed, W.M.S. et al. Assessment of articular disc displacement of temporomandibular joint with ultrasound. J Ultrasound 18, 159–163 (2015). https://doi.org/10.1007/s40477-014-0133-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40477-014-0133-2

Keywords

Search

Navigation