الفهرس | Only 14 pages are availabe for public view |
Abstract The temporomandibular joint (TMJ) has long since been established as a source of pathology. Tempomoromandibular joint disorders (TMD) is the second most common musculoskeletal condition (after chronic low back pain) resulting in pain and disability. The prevalence of TMD estimates to 35% with estimated management needs for TMD in adults at 16% It’s more common in females in younger a groups. Among the intra-articular disorders of the TMJ, disc displacement with reduction (DDWR) corresponds to 41% of TMD clinical diagnoses. Imaging of TMJ is necessary to establish the proper diagnosis, to select the appropriate treatment, and to assess the treatment results. For imaging purposes, MRI is currently considered the reference method for imaging the soft tissue structures of the TMJ (displacement and reduction of the articular disc, synovial membrane, lateral pterygoid muscle, bone marrow) .Among the disadvantages of the MRI investigation, it is costly and time consuming, restricted use in patients with claustrophobia with absolute contraindications such as cardiac pacemaker, cochlear implant, vascular clips and intra-occular foreign body. Our study was conducted on twenty one patients at Ain Shams University Hospitals. The anatomy, pathology of TMJ disc displacement, the techniques of MRI and US imaging were discussed. US were considered to be an operator-dependent technology. And, despite revealing highly sensitive and specific results in prediction of TMJ disc displacement in correlation to MRI. Some technical limitations were encountered. We concluded that HRUS is a sensitive tool for diagnosis of anterior disc displacement. Based on our current results we do not recommend HRUS as a conclusive diagnostic tool to replace MRI in cases with clinically suspected internal derangements of the TMJ. Being not as sensitive as MRI, it still can be used as an adjunct to common imaging modalities in the assessment of TMJ due to its advantages such as; non-ionizing radiation, availability, ease of usage, and providing real-time rapid images. It can be used in situations where MRI is unaffordable, unavailable which is a significant fact in Egypt. Or when contraindicated like cases with cochlear implants, pacemakers or claustrophobia. Ultrasound examination can also be used as a low cost follow up tool for assessing the impact of conservative treatment for alleviating lockjaw. |