• Journal of Oral Medicine and Pain
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• v.36 no.3
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• pp.177-185
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• 2011

Aims: The purpose of this study was to evaluate the relationship between temporomandibular joint pain and the relative signal intensity (RSI) of retrodiscal tissue on T1-, and T2-weighted MRI images. Materials and Methods: This study was based on 122 TMJs of 61 patients who complain of TMJ pain in only one side but were revealed to have disc displacement in both TMJs according to MRI findings. The signal intensities of regions of interest (ROIs) in retrodiscal tissues were measured using T1-, and T2-weighted MRI images. The RSIs of retrodiscal tissues were referenced to the signal intensities of the ROIs of brain gray matter. The relationships between the RSI of retrodiscal tissue and joint pain, joint effusion, condylar degenerative change, and degree of disc displacement were examined. In addition, the relationships between joint pain and joint effusion, condylar degenerative change, and degree of disc displacement were examined. Results: On T1-weighted MR images, the painful TMJs showed significantly higher retrodiscal tissue RSI than non-painful TMJs. In addition, there is an association between joint pain and the degree of disc displacement. However, on T2-weighted MR images, the RSIs of retrodiscal tissues didn't show any significant differences with regard to joint pain, joint effusion, condylar degenerative change, and degree of disc displacement. Conclusions: The signal intensity of retrodiscal tissue can be used as a diagnostic marker for painful TMJ. However, the overall results suggest the signal intensity of retrodiscal tissue has a limited diagnostic significance in determining the pathologic status of TMJ.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.3 no.1
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• pp.15-20
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• 2010

Purpose: The goal of this study is to find out how useful ultrasonography is in measuring amount of effusion within the knee joint in comparison with physical examination and simple radiography. Materials and Methods: We evaluated total 60 cases which were suspicious for joint effusion. Average age was 61.3 years. The group was consisted of 22 males and 38 females, and 24 obese people and 36 non-obese people. Stroke test and patella floating test were done as physical examination. Amount of joint effusion was classified into 3 groups in simple lateral radiographic view and ultrasonography was used for recheck-up. Results: 39 cases were found positive in stroke test, and patella floating was shown in 20 cases. In simple lateral radiographic view, 47 cases of grade I, 7 cases of grade II and 3 cases of grade III were checked. Average $7.67{\pm}2.90mm$ amount of effusion was checked by ultrasonography. Amount of fluid in stroke test, patella floating test and simple lateral radiographic view showed close correlation with ultrasonography. Gender did not seem to affect physical examination, but strong correlation was found in female in simple radiography. Obese group showed closer relationship with all 3 exams compared with non-obese group. Physical examination was relatively effective with nonobese group, but not with obese group. And it was not easy to measure the amount of fluid with simple radiographic view, but we could obtain objective data from ultrasonography by measuring the amount of effusion dynamically. Conclusion: We concluded that more objective data was obtained with ultrasonography in comparison with physical examinations and simple radiography in the aspect of measuring amount of joint fluid.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.44 no.3
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• pp.120-127
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• 2018

Objectives: The aim of this study was to reveal how collagenases (matrix metalloproteinase [MMP]-1, 8, 13) and tissue inhibitor of metalloproteinase 1 (TIMP-1) are expressed in immunohistochemistry of retrodiscal tissue in temporomandibular joint disorder patients. Materials and Methods: This study was conducted on 39 patients who underwent discoplasty or discectomy. Immunohistochemical staining was undertaken and expression levels of MMP-1, 8, 13, and TIMP-1 were evaluated. The status of internal derangement of disc, osteoarthritis, and joint effusion were analyzed using magnetic resonance imaging (MRI). Disc status observed during operation was also categorized. Results: The more severe disc derangement was observed on MRI, the more increased expression of MMPs and TIMP-1 appeared. Regarding MMP-13 expression, 86.7% of late-stage disc displacement patients showed grade II or III. Expression level of MMPs or TIMP was not statistically significant associated with joint effusion level. In perforation and/or adhesion groups, all patients showed grade II or III expression of MMP-13. Once perforation occurred, MMP-13 showed increased expression with statistical significance. Conclusion: MMP-1 and MMP-13 expression seem to be related to progression of osteoarthritis whereas MMP-8 does not seem to have a specific role with regard to temporomandibular joint disorders. TIMP-1 is considered to be partly related to internal derangement rather than osteoarthritis, but it is not significant.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.31 no.5
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• pp.399-408
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• 2005

In the progression of the Temporomandibular Joint Disorder(TMD), not only deformation and perforation of disc occur. But also fibrotic adhesion and inflammatory changes to the retrodiscal tissue can be seen in addition to the condylar degenerative change (e.g. osteoarthritis). However, the correct diagnosis,?planning for appropriate treatment, and prediction of prognosis are limited, because there are no means to stage the progression of the disorder. In this study relative signal intensity of retrodiscal tissue in MRI and the synovial fluid concentration of matrix metalloproteinase-2 (MMP-2), MMP-9, and Interleukin-6(IL-6) in the 23 temporomandibular joints(TMJ), from 17 patients with TMD were evaluated as a possible diagnostic marker. The relative signal intensity of retrodiscal tissue was referenced to brain gray matter with same region of interest(ROI) size. The concentrations of MMP-2, MMP-9, and IL-6 were evaluated by Enzyme Linked Immunosorbent Assay (ELISA). The collected data were compared with condylar degenerative change, joint effusion and disc position observed in MRI. The relative signal intensity of the retrodiscal tissue was increased significantly when degenerative changes were present. In addition, there was significantly high signal intensity in the presence of a disc displaced without reduction. The concentration of IL-6 was significantly increased when condylar degenerative change was no observed. And there were no changes in the levels of IL-6 according to disc position and joint effusion measurement. Moreover, there were no significant relevance between the concentration of total MMP-2 and active MMP-9 in synovial fluid, relative to degenerative changes in the mandibular condyle, to joint effusion, and to disc position observed on MRI images. In conclusion, the relative signal intensity of the retrodiscal tissue can be regarded as a mean of diagnosing the procession of TMD in a non-invasive manner. But more additional studies are required for the levels of MMP-2. MMP-9, and IL-6 to determine their potentials as a diagnostic marker for TMD.

• Journal of Oral Medicine and Pain
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• v.46 no.1
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• pp.14-19
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• 2021

Various conditions such as pain or effusion of temporomandibular joint, degenerative condylar resorption, and articular disc displacement can be a cause of malocclusion. However, the reasons of occlusal changes are ambiguous in some patients. Unexpected occlusal change in patients with or without temporomandibular disorder (TMD) symptom was mostly caused by masticatory muscular disorders. This article reports two cases of recovery of occlusal relationship in TMDs patients after stabilization splint therapy. Stabilization splint therapy could be useful in certain conditions of occlusal changes in TMD.

• Tuberculosis and Respiratory Diseases
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• v.67 no.1
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• pp.32-36
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• 2009

We report a case of disseminated Mycobacterium intracellulare infection in a 31-year-old man who had been diagnosed as having dermatomyositis and systemic lupus erythematosus 3-years prior. The patient developed a left pleural effusion M. intracellulare was repeatedly isolated from the pleural fluid. After antimycobacterial treatment, the patient's pleural effusion resolved, but a left knee joint effusion developed newly and M. intracellulare was cultured from the joint fluid. At present, the patient has been taking antimycobacterial medication for 15 months but his left knee joint fluid remains positive for M. intracellulare. To our knowledge, this is the second reported case of disseminated NTM infection in a non-HIV infected patient in Korea.

• Journal of Oral Medicine and Pain
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• v.48 no.3
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• pp.106-111
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• 2023

Purpose: In this study, we evaluate the potential of the relative ratio of capsular width (RCW) between the affected side (Aff) and non-affected side (Non-aff) in patients with temporomandibular joint (TMJ) arthralgia. We assessed whether RCW may hold greater diagnostic significance than the objective capsular width (CW) reported in previous studies when diagnosing arthralgia using ultrasonography (US). Methods: Forty-nine patients were assessed using US, excluding four patients with bilateral arthralgia. The patients were divided into two groups: 40 with unilateral arthralgia (UA), and nine without arthralgia (NA). We measured CW and masseter muscle thickness using US. Moreover, we employed RCW to analyze the variances between the groups. The numerical rating scale (NRS) and RCW were compared before and after dexamethasone injection in 10 patients who underwent follow-up evaluations. Results: Within the UA group, CW on the Aff was found to be significantly larger compared to the Non-aff (p<0.001). Additionally, RCW in the UA group was greater than that in the NA group (p<0.01). Furthermore, after dexamethasone injection, a reduction in the NRS and RCW values was observed in the 10 patients who were followed up. Conclusions: While previous studies have suggested a link between arthralgia and TMJ effusion, making CW a possible indirect diagnostic indicator for arthralgia, our findings propose that RCW could hold more diagnostic value than objective CW. However, additional studies are required to standardize the protocols for interpreting US results and determining the cutoff value of RCW in diagnosing TMJ arthralgia.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.27 no.5
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• pp.457-462
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• 2005

The aim of this study is to evaluate the relative signal intensity of TMJ retrodiscal tissue in T2-weighted MRI as diagnostic marker of temporomandibular disorder(TMD). 58 temporomandibular joints from 29 TMD patients (14 men & 15 women) were evaluated. The relative signal intensity of retrodiscal tissue in T2-weighted MRI was referenced to brain gray matter same size of the region of interest(ROI). The collected data was compared to disc positions (normal, anterior disc displacement with reduction, anterior disc displacement without reduction), the presence of joint effusion. The relative signal intensity of retrodiscal tissue was significantly increased when the disc was displaced without reduction. And the relative signal intensity of retrodiscal tissue was significantly increased when joint effusion was present. The results suggest that evaluating the relative signal intensity of TMJ retrodiscal tissue using a T2-weighted MRI is valuable as a non-invasive tool for diagnosing the procession of TMD.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.5 no.2
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• pp.112-117
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• 2012

Septic arthritis of the elbow is a rare, but serious disorder in neonates. However, neonates often present with few systemic signs other than irritability or poor feeding. When the clinical findings are minimal or absent, joint aspiration gives us helpful information in making a diagnosis. Although many clinicians rely on its result, we experienced a case of early clotted joint effusion, which resulted negative joint aspiration in a neonate with septic elbow arthritis. Ultrasonography helped us to make an early decision to perform surgical intervention as showing different echogenicity of intracapsular portion from generally presented in septic effusion. Presenting case shows that ultrasonography can be an excellent second step examination of neonatal elbow presenting atypical clinical findings of septic arthritis.

• Imaging Science in Dentistry
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• v.35 no.2
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• pp.69-75
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• 2005

Purpose : To determine the clinical correlation of magnetic resonance imaging (MRI) findings of temporomandibular joint internal derangements. Materials and Methods : The MR images of 150 TMJs in 75 patients were analyzed. The clinical symptoms were pain in the preauricular area and masticatory muscles and TMJ sounds. Results : There was a statistically significant relationship between the MRI diagnoses of different types of disc displacements and clinical findings of pain, clicking, and crepitus. The risk of TMJ pain was increased when the disc displacement without reduction occurred at the same time in combination with the osteoarthrosis and effusion. Conclusion : Regardless of the results, the data indicate that each of these MR imaging variables may not be regarded as the unique and dominant factor in defining TMJ pain occurrence.