الفهرس 
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Abstract
Ultrasonography is a cheap, available, noninvasive, real time, static, and dynamic imaging technique that provides an understanding of the dynamics of the TMJ. It has been used widely in assessing TMJ pathology, disk displacement, to study joint spaces and condylar position, and to study the distance between the articular capsule and the lateral surface of the mandibular condyle, joint anatomy.
Ultrasonography is persistently developing since its first use in the medical field. These days, ultrasound systems with high-frequency transducers provide a speedy and exact appraisal of the little joints encompassing delicate tissues. Ultrasound of the TMJ is generally agreeable to the patient, with minimal effort and high accessibility, providing data regarding degenerative changes, vicinity of articular effusion and disc displacement. Ultrasound can be utilized for diagnosing TMJ disc position irregularities at closed-mouth position and also at open-mouth position.
The aim of this study is to evaluate the role of ultrasonography as a diagnostic tool for screening of temporomandibular joint dysfunction.
The current study was conducted on 400 joints of 200 cases (148) females and (52) males. Their ages ranged from 7 to 80 years.
All cases were subjected to the following:
•History taking.
•Clinical examination.
•Ultrasonographic examination of both TMJs using high frequency linear transducer.
Ultrasound examination was performed with a high-resolution 5.0-10 MHz linear probe of SIEMENS ACUSON (X300) premium apparatus and high resolution 5.0-12 MHz linear probe of PHILIPS HD9 ultrasound apparatus. Patients were in a supine position. Ultrasonographic investigation was done with longitudinal and transverse scans in the closed (static) and open (dynamic) mouth positions by 2D and 3D scanning, with the transducer overlying the TMJ and the zygomatic arch. The transducer tilted over its long axis was necessary to obtain optimal visualization of the joint.
In all scans, we measured the distance between the most lateral point of the articular capsule and the most lateral point of the mandibular condyle (Lateral capsular condyle distance). On ultrasonography, normal disc could be identified as hyperechoic structure surrounded by an echogenic line, corresponding to the articular capsule. The condylar surface was depicted in longitudinal scan as hyper echoic line, whose irregularities suspect presence of erosion or bone remodeling.
In this study we have 356 normal joints, 18 joints of osteoarthritic changes, 12 joints of joint effusion, 5 joints of osteoarthritis and disc displacement, 4 joints of disc displacement, 4 of joint effusion and osteoarthritic changes and one joint of disc displacement with joint effusion.
In our study the mean normal values (± standard deviation) for the capsule-condyle distance in the closed-mouth position were 1.5±0.26 mm in transverse scans and 1.3 ± 0.24 mm in longitudinal scans. The mean value in the open-mouth position, for transverse scans 1.2±0.25 mm and for longitudinal scans was 1.2±0.25 mm.
While in joint effusion; the mean values (± standard deviation) for the capsule-condyle distance in the closed-mouth position were 2.6±0.29.