Document Detail


Bone marrow edema of the mandibular condyle related to internal derangement, osteoarthrosis, and joint effusion.
MedLine Citation:
PMID:  12524605     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: The purpose of this prospective study was to evaluate whether common magnetic resonance imaging (MRI) variables such as temporomandibular joint (TMJ) internal derangement, osteoarthrosis, and effusion may predict the diagnostic group of bone marrow edema of the mandibular condyle. MATERIALS AND METHODS: The relationship between bone marrow edema and TMJ disc displacement, osteoarthrosis, and effusion was analyzed in MRIs of 120 TMJs in 73 consecutive patients with TMJ pain and/or a clinical diagnosis of TMJ internal derangement type III (disc displacement without reduction). The diagnostic bone marrow edema group was comprised of 54 TMJs in 40 patients with a unilateral or bilateral MRI diagnosis of bone marrow edema. The control group consisted of 66 non-bone marrow edema TMJs in 33 patients with a bilateral MRI finding of an absence of bone marrow edema. A logistic regression analysis was used to compute the odds ratios for internal derangement, osteoarthrosis, and effusion for non-bone marrow edema TMJs (n = 66) versus TMJs with bone marrow edema (n = 54). RESULTS: Using Chi;(2) analysis for pair-wise comparison, the TMJ-related data showed a significant relationship between the MR imaging findings of TMJ bone marrow edema and those of internal derangement (P = .000), osteoarthrosis (P = .000), and effusion (P = .010). Of the MRI variables considered simultaneously in the multiple logistic regression analysis, osteoarthrosis (P = .107) and effusion (P = .102) dropped out as nonsignificant in the diagnostic bone marrow edema group when compared with the control group. The odds ratio for individuals with an internal derangement showing bone marrow edema was strong (3.6:1) and highly significant (P = .000). Significant increases in risk of bone marrow edema occurred with disc displacement without reduction and osteoarthrosis (9.2:1) (P = .000) and disc displacement without reduction and effusion (6.4:1) (P = .002). CONCLUSIONS: The results suggest that the MR imaging findings for TMJ bone marrow edema are related to those of internal derangement, osteoarthrosis, and effusion. However, the data re-emphasize the aspect that internal derangement, osteoarthrosis, and effusion may not be regarded as the unique and dominant factors in defining TMJ bone marrow edema instances.
Authors:
Rüdiger Emshoff; Iris Brandlmaier; Christoph Schmid; Stefan Bertram; Ansgar Rudisch
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons     Volume:  61     ISSN:  0278-2391     ISO Abbreviation:  J. Oral Maxillofac. Surg.     Publication Date:  2003 Jan 
Date Detail:
Created Date:  2003-01-13     Completed Date:  2003-01-29     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8206428     Medline TA:  J Oral Maxillofac Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  35-40     Citation Subset:  AIM; D; IM    
Copyright Information:
Copyright 2003 American Association of Oral and Maxillofacial Surgeons
Affiliation:
Department of Oral and Maxillofacial Surgery, University of Innsbruck, Innsbruck, Austria. Ruediger_Emshoff@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Analysis of Variance
Bone Marrow Diseases / complications*,  physiopathology
Chi-Square Distribution
Dislocations / complications*,  physiopathology
Edema / complications*,  physiopathology
Female
Humans
Logistic Models
Magnetic Resonance Imaging
Male
Mandibular Condyle / pathology*
Mandibular Diseases / complications,  physiopathology
Matched-Pair Analysis
Middle Aged
Odds Ratio
Osteoarthritis / complications*,  physiopathology
Prospective Studies
Risk Factors
Synovial Fluid / physiology*
Temporomandibular Joint Disk / pathology*
Temporomandibular Joint Disorders / complications*,  physiopathology

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