EFFECTIVENESS OF ULTRASONOGRAPHY IN DETECTING DISC DISPLACEMENTS AND EFFUSION IN TEMPOROMANDIBULAR JOINTS

Abstract

Introduction. Ultrasonography (US) has gained significant popularity in diagnosing temporomandibular disorders (TMDs). However, the effectiveness of using US for examining the temporomandibular joints (TMJs) to diagnose TMDs, particularly disc displacements (DD) and joint effusion (JE), remains a subject of debate. The aim of the study. To determine the effectiveness of USG in diagnosing disc displacements and effusion in TMJ. Research materials and methods. The study included 33 patients aged 18 to 64 years who underwent US and MRI of the right and left TMJs. Using US, the following parameters were examined to detect DD in TMJs: disc position relative to the condyle with closed teeth in habitual occlusion, ultrasonographic characteristics of condyle movement, disc position relative to the condyle with maximum mouth opening, and for detecting JE: width of the joint space. For diagnosing DD in TMJs and determining its type on MRI, the following parameters were evaluated: disc position relative to the condyle with closed mouth in habitual occlusion (PD pulse sequence), movement of the condyle and disc during mouth opening and closing, disc position relative to the condyle and eminence with maximum mouth opening. MRI examination for detecting JE in TMJs was performed using T2/ FS pulse sequence. Effusion was visualized as individual dots, bands, or a massive area in the TMJ area with high signal intensity. Results. The calculated parameters of US effectiveness in detecting DD in TMJs (overall) were as follows: sensitivity – 57,14%, specificity – 83,33%, overall accuracy – 66,67%, positive predictive value (PPV) – 85,71%, negative predictive value (NPV) – 52,63%. When studying the effectiveness of US depending on the type of DD, the following data were obtained for DD with reduction: sensitivity – 40,00%, specificity – 89,13%, overall accuracy – 74,24%, PPV – 61,5%, NPV – 77,36%. For DD without reduction: sensitivity – 45,45%, specificity – 88,64%, overall accuracy – 74,24%, PPV – 66,67%, NPV – 76,47%. Regarding JE in TMJs: sensitivity – 33,33%, specificity – 91,67%, overall accuracy – 75,76%, PPV – 60,00%, NPV – 78,57%. Conclusions. Considering the sensitivity and specificity of USG for DD with and without reduction and JE of the TMJ (sensitivity was 40, 45,45, 33,33%, respectively, and specificity – 89,13, 88.64, 91,67%), ultrasound is more advisable to use for excluding the mentioned diagnoses rather than confirming them.