Diagnostic performance of magnetic resonance imaging for degenerative temporomandibular joint disease

J Oral Rehabil. 2023 Jan;50(1):24-30. doi: 10.1111/joor.13386. Epub 2022 Nov 9.

Abstract

Background: Degenerative joint disease (DJD) of the temporomandibular joint (TMJ) is an important type of temporomandibular disorders (TMDs) potentially leading to orofacial pain and jaw dysfunction. Magnetic resonance imaging (MRI) is important in TMD diagnosis; however, its diagnostic ability for DJD remains unknown.

Objective: To explore the utility of MRI in diagnosing DJD according to the latest diagnostic criteria for TMD and detecting condylar bone abnormalities and their severity.

Methods: Overall, 122 participants were examined using cone-beam computed tomography (CBCT) and MRI. The sensitivity, specificity and accuracy of MRI for detecting DJD and different types of TMJ condylar bone abnormalities were calculated (considering CBCT as gold standard); in addition, we tested MRI and CBCT's consistency in scoring five types of condylar bone abnormalities.

Results: The sensitivity and specificity of MRI for DJD were 95.3% and 43.1%, respectively. The MRI sensitivities for condylar flattening, erosion, osteophytes, sclerosis and cysts were 98.6%, 96.2%, 79.4%, 50%, and 79.2% (specificity, 53.6%, 48.3%, 81.6%, 83.3%, and 88.2%, respectively), respectively. The consistency between MRI and CBCT in assessing the severity of condylar bone abnormalities was fair-to-moderate (kappa coefficient: 0.278-0.491). The inter-observer consistency for CBCT was good, whereas for MRI, it was relatively poor.

Conclusion: MRI can detect DJD and condylar bone abnormalities. However, MRI could not efficiently detect the severity of condylar bone abnormalities.

Keywords: cone-beam computed tomography; diagnostic imaging; magnetic resonance imaging; sensitivity and specificity; temporomandibular joint; temporomandibular joint disorders.

MeSH terms

  • Cone-Beam Computed Tomography / methods
  • Humans
  • Magnetic Resonance Imaging* / methods
  • Sensitivity and Specificity
  • Temporomandibular Joint Disorders* / diagnosis
  • Temporomandibular Joint Disorders* / diagnostic imaging
  • Temporomandibular Joint* / diagnostic imaging
  • Temporomandibular Joint* / pathology