Mu-Chen Yang1, Ding-Han Wang1, Hung-Ta Wu2, Wan-Chun Li1,3,4, Tsai-Yu Chang1, Wen-Liang Lo5,6, Ming-Lun Hsu7. 1. Department of Dentistry, School of Dentistry, National Yang-Ming University, No. 155, Li-Nong Street, Section 2, Taipei, 11221, Taiwan. 2. Department of Radiology, Taipei Veterans General Hospital, No. 201, Sec. 2, Shih-pai Road, Taipei, 11217, Taiwan. 3. Institute of Oral Biology, School of Dentistry, National Yang-Ming University, No. 155 Li-Nong Street, Section 2, Taipei, 11221, Taiwan. 4. Cancer Progression Center, National Yang-Ming University, No. 155 Li-Nong Street, Section 2, Taipei, 11221, Taiwan. 5. Department of Dentistry, School of Dentistry, National Yang-Ming University, No. 155, Li-Nong Street, Section 2, Taipei, 11221, Taiwan. wllo@vghtpe.gov.tw. 6. Division of Oral and Maxillofacial Surgery, Department of Stomatology, Taipei Veterans General Hospital, No. 201, Sec. 2, Shih-pai Road, Taipei, 11217, Taiwan. wllo@vghtpe.gov.tw. 7. Department of Dentistry, School of Dentistry, National Yang-Ming University, No. 155, Li-Nong Street, Section 2, Taipei, 11221, Taiwan. mlhsu@ym.edu.tw.
Abstract
OBJECTIVES: Magnetic resonance imaging (MRI) is a standardized method for assisting joint diagnosis. To validate the reliability of different imaging-based grading systems, this study examined (1) the associations between grading systems for osseous change, joint effusion, and the Wilkes classification of temporomandibular joint (TMJ) disorders and (2) the correlation between cytokines in synovial fluid and imaging-based joint scores. MATERIALS AND METHODS: Twenty-seven patients, who routinely received numeric rating scale (NRS) and MRI assessment before TMJ arthrocentesis, were enrolled. Each joint was evaluated through the grading criteria for severity of osseous change and joint effusion by blinded observers using MRI. ImageJ was employed for classifying joint effusion. Joint synovial fluid, collected through arthrocentesis, was examined for cytokine expression by using a Luminex multiplex assay. All data were analyzed using the Pearson correlation analysis. RESULTS: The Wilkes classification was strongly correlated with osseous change scores, but not with joint effusion scores. Joint effusion scores significantly correlated with NRS scores, but not with the Wilkes classification and osseous change scores. Compared with osseous change scores, joint effusion scores had a higher correlation with the levels of inflammatory cytokines (interleukin (IL)-8 and soluble IL-6 receptor (sIL-6R)) and with anti-inflammatory cytokines (soluble tumor necrosis factor receptors I and II (sTNF-RI/II)). CONCLUSIONS: In patients with TMJ disorders, MRI grades are strongly correlated with NRS scores and levels of cytokines (IL-8, sIL-6R, and sTNF-RI/II) in the synovial fluid. CLINICAL RELEVANCE: Joint effusion scoring can be a reliable and valid indicator for pathological assessment of TMJ disorders.
OBJECTIVES: Magnetic resonance imaging (MRI) is a standardized method for assisting joint diagnosis. To validate the reliability of different imaging-based grading systems, this study examined (1) the associations between grading systems for osseous change, joint effusion, and the Wilkes classification of temporomandibular joint (TMJ) disorders and (2) the correlation between cytokines in synovial fluid and imaging-based joint scores. MATERIALS AND METHODS: Twenty-seven patients, who routinely received numeric rating scale (NRS) and MRI assessment before TMJ arthrocentesis, were enrolled. Each joint was evaluated through the grading criteria for severity of osseous change and joint effusion by blinded observers using MRI. ImageJ was employed for classifying joint effusion. Joint synovial fluid, collected through arthrocentesis, was examined for cytokine expression by using a Luminex multiplex assay. All data were analyzed using the Pearson correlation analysis. RESULTS: The Wilkes classification was strongly correlated with osseous change scores, but not with joint effusion scores. Joint effusion scores significantly correlated with NRS scores, but not with the Wilkes classification and osseous change scores. Compared with osseous change scores, joint effusion scores had a higher correlation with the levels of inflammatory cytokines (interleukin (IL)-8 and soluble IL-6 receptor (sIL-6R)) and with anti-inflammatory cytokines (soluble tumor necrosis factor receptors I and II (sTNF-RI/II)). CONCLUSIONS: In patients with TMJ disorders, MRI grades are strongly correlated with NRS scores and levels of cytokines (IL-8, sIL-6R, and sTNF-RI/II) in the synovial fluid. CLINICAL RELEVANCE: Joint effusion scoring can be a reliable and valid indicator for pathological assessment of TMJ disorders.
Entities:
Keywords:
Cytokines; Joint effusion; Magnetic resonance imaging; Temporomandibular joint
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