PURPOSE: The aim of this study was to investigate the ability of clinical and magnetic resonance imaging (MRI) diagnoses to predict pain in the temporomandibular joint (TMJ). MATERIALS AND METHODS: One hundred forty-nine patients were examined by 2 calibrated examiners in strict accordance with the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). All patients who presented with a defined clinical RDC/TMD diagnosis were included and underwent bilateral coronal and sagittal MRI of the TMJ. Two raters blinded to the clinical diagnosis interpreted the MRI scans for TMJ pathology. The results were tested against the clinical diagnosis according to the RDC/TMD, including pain-related disability and psychosocial status, for associations to TMJ arthralgia using logistic regression analysis (GENMOD procedure, P < .05). RESULTS: MRI-depicted anatomic changes, such as joint effusions, disc displacement, and osteoarthrosis, were not significantly correlated with the presence of pain in the TMJ. However, a significant relationship between pain on palpation of the masseter muscle origin (P = .0050) and psychosocial factors (P = .0452) and pain in the TMJ was demonstrated. CONCLUSIONS: Pain in the TMJ caused by the anatomic proximity of the muscle masseter origin and the lateral TMJ pole and the possible existence of trigger points in the musculature may lead to a false-positive or a false-negative diagnosis of arthralgia. Additionally, clinicians must consider the psychosocial aspects of pain in ideal treatment planning.
PURPOSE: The aim of this study was to investigate the ability of clinical and magnetic resonance imaging (MRI) diagnoses to predict pain in the temporomandibular joint (TMJ). MATERIALS AND METHODS: One hundred forty-nine patients were examined by 2 calibrated examiners in strict accordance with the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). All patients who presented with a defined clinical RDC/TMD diagnosis were included and underwent bilateral coronal and sagittal MRI of the TMJ. Two raters blinded to the clinical diagnosis interpreted the MRI scans for TMJ pathology. The results were tested against the clinical diagnosis according to the RDC/TMD, including pain-related disability and psychosocial status, for associations to TMJ arthralgia using logistic regression analysis (GENMOD procedure, P < .05). RESULTS: MRI-depicted anatomic changes, such as joint effusions, disc displacement, and osteoarthrosis, were not significantly correlated with the presence of pain in the TMJ. However, a significant relationship between pain on palpation of the masseter muscle origin (P = .0050) and psychosocial factors (P = .0452) and pain in the TMJ was demonstrated. CONCLUSIONS:Pain in the TMJ caused by the anatomic proximity of the muscle masseter origin and the lateral TMJ pole and the possible existence of trigger points in the musculature may lead to a false-positive or a false-negative diagnosis of arthralgia. Additionally, clinicians must consider the psychosocial aspects of pain in ideal treatment planning.
Authors: Liliane R Gomes; Marcelo Gomes; Bryan Jung; Beatriz Paniagua; Antonio C Ruellas; João Roberto Gonçalves; Martin A Styner; Larry Wolford; Lucia Cevidanes Journal: J Med Imaging (Bellingham) Date: 2015-07-07
Authors: Eric L Schiffman; Richard Ohrbach; Edmond L Truelove; Feng Tai; Gary C Anderson; Wei Pan; Yoly M Gonzalez; Mike T John; Earl Sommers; Thomas List; Ana M Velly; Wenjun Kang; John O Look Journal: J Orofac Pain Date: 2010
Authors: C C Peck; J-P Goulet; F Lobbezoo; E L Schiffman; P Alstergren; G C Anderson; R de Leeuw; R Jensen; A Michelotti; R Ohrbach; A Petersson; T List Journal: J Oral Rehabil Date: 2014-01 Impact factor: 3.837
Authors: Eric L Schiffman; Edmond L Truelove; Richard Ohrbach; Gary C Anderson; Mike T John; Thomas List; John O Look Journal: J Orofac Pain Date: 2010
Authors: Edmond Truelove; Wei Pan; John O Look; Lloyd A Mancl; Richard K Ohrbach; Ana M Velly; Kimberly H Huggins; Patricia Lenton; Eric L Shiffman Journal: J Orofac Pain Date: 2010