AUTHOR(S): Altaf Hussain Chalkoo, Dr. Zahoor Ahmad Bhat and Dr Anum Maqbool

ABSTRACT:Objectives: Pain caused by temporomandibular disorders originates from either muscular or articular conditions, or both. Distinguishing the precise source of the pain is a significant diagnostic challenge to clinicians, and effective management hinges on establishing a correct diagnosis temporomandibular joint (TMJ) dysfunction is a common condition that is best evaluated with magnetic resonance (MR) imaging. The important step in MR imaging of the TMJ is to evaluate the articular disk, or meniscus, in terms of its morphologic features and its location relative to the condyle in both closed- and open-mouth positions. Disc location is of prime importance because the presence of a displaced disk is a critical sign of TMJ dysfunction. However asymptomatic volunteers can have disc displacement. It is important for the maxillofacial radiologist to detect early MR imaging signs of dysfunction, thereby avoiding the evolution of this condition to its advanced and irreversible phase which is characterized by osteoarthritic changes such as condylar flattening or osteophytes. Henceforth, the aim of the study was to evaluate MRI Characteristics of Disc Displacement of temporomandibular disorders and its correlation with clinical findings in symptomatic and asymptomatic subjects Materials and Methods: In this clinical study, 30 patients (60 TMJs) were examined clinically and divided into two groups. Group 1 consisted of 15 patients with clinical signs and symptoms of TMDs either unilaterally or bilaterally and considered as study group. Group 2 consisted of 15 patients with no signs and symptoms of TMDs and considered as control group. MRI was done for both the TMJs of each patient. Displacement of the posterior band of articular disc in relation to the condyle was quantified as anterior disc displacement with reduction (ADDR), anterior disc displacement without reduction (ADDWR), posterior disc displacement (PDD). Results: Disk displacement was found in 13 (86.7%) patients of 15 symptomatic subjects in Group 1 on MRI and 2 (13.3%) were diagnosed normal with no disc displacement. In Group 2, 1(6.7%) of 15 asymptomatic patients were diagnosed with disc displacement while 14 (93.3%) were normal. Sensitivity and Specificity tests were applied in both the groups to correlate MRI characterstics of disc displacement and clinical finding of TMD and results showed Sensitivity of 92.9% and Specificity of 87.5%. Conclusion: Disk displacement on MRI correlated well with presence or absence of clinical signs and symptoms of temporomandibular disorders with high Sensitivity and Specificity of 92.9% and 87.5% respectively.

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