Magnetic resonance imaging evaluation of temporo-mandibular joint disorders, criterial analysis and significance in comparison with arthroscopy

Aim: The aim of our study was to analyze magnetic resonance imaging criteria in assessment of TMJ disorders and evaluate the important MRI role in comparison with arthroscopy. Patients and methods: The study was performed on eighty TMJs. TMJs are examined by 1.5 tesla MRI machine using sagittal oblique T1, PD & T2 weighted images & coronal oblique T1 and PD weighted images. The disk position, configuration, presence or absence of joint effusion, osteo-arthritis and mandibular condyle morphology were assessed. Comparison was done with arthroscopy in 49 joints. Results: Disk displacement was found in all cases symptomatic 80 joints, 60% bilateral and 40% unilateral. Joint pain and tenderness were the most clinical symptom followed by joint noise/clicking. Thirty-five joints showed anterior disk displacement with reduction, while forty-five joints showed anterior disk displacement without reduction and one of them shows stuck disk in displaced position. MRI has sensitivity of 95, specificity of 88 and accuracy of 94 in comparison with arthroscopy. Conclusion: MRI is proper diagnostic modality for TMJ disorders due to non invasiveness, excellent soft tissue contrast and multiplaner capabilities.