Comparison of clinical diagnosis and findings with MR imaging results in patients with temporomandibular injury

The aim of this clinical study was to analyze the relationship between the clinical symptoms and MRI findings in individuals with temporomandibular joint disorders (TMD). 55 clinically diagnosed patients with internal derangement of TMJ and a total of 110 joints were studied. Detailed history were obtained from the selected patients. Muscle, joint and intraoral examinations were performed. Pain was recorded on a visual analog scale (VAS) numbered between 0-10. The examination findings were recorded on an examination form and these patients underwent MRI. In 55 patients, magnetic resonans (MR) images were obtained with the mouth open and closed position of 110 joints T1- and T2-weighted spin-echo and spoiled gradient-recalled (SPGR), MR imaging was performed. MRI examination results were evaluated according to routine reporting protocol. The relationship between clinical diagnosis and MRI findings were statistically evaluated. The data were analysed with Kappa Test. P values < .05 were considered to indicate statistical significance. The relationship between gender and pain, joint sounds, deviation / deflection, feeling of locking, stress, and muscle condition was examined with Fisher's Exact Test. No relation between variables and gender was evaluated (p>0.05). It was concluded that variables such as degenerative changes in the disc and condyle evaluated in the routine evaluation protocol of MRI examinations, edema and fluid accumulation in the joint space were observed at a higher rate in the joints diagnosed with disc displacement without reduction. The diagnostic accuracy of the clinical symptoms and MRI findings had a sensivity of 65% for patients with disc displacement with reduction and 83% for patients with disc displacement without reduction.