Two of the methods for the examination of inflammatory changes in the synovial fluid of TMJ are ; aspiration and magnatic resonance imaging. While the aspiration method is invasive and limited by technical difficulties, magnatic resonance
imaging,
which
could be classified as T1 or T2-weighted images, could visualize changes in volume and content of synovial fluid by inflammation through T2-weighted images only. Such inflammatory changes are among the factors causing pain in TMJ, and imaged as
joint
effusion, which is a high signal intensity within the joint cavities, and edema of posterior attachment. This detection of internal changes may be important in the choice of the method and prognosis of the treatment for TMJ.
This study compared and analyzed T1 and T2-weighted images and examined T2-weighted images of joint effusion and edema from those patients who were tenatively diagnosed with internal derangement.
@ES The results were as follows:
@EN 1. Among the total of 128 patients and 131 joints, 13% were normal, 38.2% were anterior displacement with reduction, 42.7% were anterior displacement without reduction, and 6.1% were perforations. When morphological changes of meniscus were
present,
they appeared in 26 joints with the anteior displacement with reduction, and in most of the anterior displacement without reduction. Degenerative changes of the condyle heads were observed in 20 joints with anterior displacement without
reduction,
and
in all 8 cases with perforation.
2. Joint effusion and edema images on MR T2-weihgted images were present in 59 out of 131 joints(45.1%).
3. Presents of joint effusion was rare in normal and slight disc displacement cases, most frequent in the advanced disc displacement cases, and as it progressed toward perforation, tend to be rare again. That seems to indicated that joint
effusion
is
associated with disc displacement.
4. Association between joint effusion and pain was highly significant ; displacement with reduction showed 81.8%, without reduction 88.6% with total of 86.4%.
5. In the diagnosis of TMJ through magnetic resonance imaging, T2-weighted images can detect pathological changes and therefore seem to be more effective than the routine T1-weighted images.
|