Magnetic Resonance Imaging as a Diagnostic Tool in Temporomandibular Joint Disorders (TMD)

Objectives: TMD is a general term for diseases of the temporomandibular joint (TMJ), which affects one third of adults. The symptoms of TMD generally include pain in the TMJ and masticatory muscles, joint sounds and locking, and alteration of mandibular movement.

MRI has become the standard examination of the TMJ. Because the signal intensity of the different components of the joint varies, the structure of the TMJ can be displayed better using MRI than other imaging methods in addition to the absence of radiation and invasion.

Due to its anatomic and physiological complexities, the TMJ poses a considerable challenge to therapeutic and diagnostic procedures. Understanding the radiological picture is challenging because of the various MRI sequences and methods. The clinician should be familiar with the MRI picture in the different sequences and the correlation with the clinical findings especially if a TMJ surgery is planned.

Our study checked a correlation between two groups of TMJ pathologies and MRI findings.

Methods: 51 patients diagnosed with TMD were included in our study. All patients were checked by the same oral medicine specialist and oral and maxillofacial surgeon.

The patients were diagnosed with different TMJ pathologies such as internal derangement, osteoarthritis, and rheumatological diseases.

All patients were sent to an MRI scan and several variables and sequences were examined.

Results: Presence of several findings such as synovial fluid in T2W, thickening of synovium in T1W with contrast FSE sequences were correlated with severe pain and limited mouth opening.

Location of the articular disc was determined by dynamic sequences and correlated to joint noises.

Conclusion: In most of the cases the MRI added important information to clinical diagnosis especially concerning disc position and status Our study emphasizes the use of MRI as an important diagnostic tool in TMD, especially when the treatment plan includes surgical intervention.