Marcelo Eduardo Pereira Dutra

Correlation among the changes observed in temporomandibular joint internal derangements assessed by magnetic resonance in symptomatic patients.

PURPOSE The objective was to assess possible correlations among the anatomy and position of the articular disc, the morphology of the articular eminence and of the condyle, and the presence of joint effusion. MATERIALS AND METHODS Magnetic resonance images of 142 joints of symptomatic patients were assessed. The articular disc was classified as normal, elongated, or folded; displacement was classified as normal, anterior with reduction, anterior without reduction, or posterior, lateral, or medial; the condyle was classified as rounded, convex, flattened, or angulated; and the articular eminence was classified as box, sigmoid, flattened, or deformed. RESULTS The most frequent forms of the articular disc, articular eminence, and condyle were normal, box, and flattened, respectively. Associations were confirmed between the form of the articular disc and its anterior and lateral positions; between the form of the condyle and an anterior position of the disc; and between the form of the articular eminence and the form of the disc. The form of the articular eminence was the only variant that was not associated to the presence of joint effusion. CONCLUSIONS Magnetic resonance imaging allowed the clear observation of articular structures, without attributing a cause-and-effect relation. The prevalence of changes observed was associated with the diagnosis of internal derangement and was statistically proved.

Assessing joint effusion and bone changes of the head of the mandible in MR images of symptomatic patients

The aim of the present study was to investigate the relationship between degenerative bone changes of the head of the mandible and the presence of joint effusion (JE). This study was based on sagittal magnetic resonance imaging (MRI) reports of 148 temporomandibular joints (TMJs) of 74 patients complaining of pain and/or dysfunction in the TMJ area. The mandible heads were surveyed for osteoarthritis characteristics, which were classified as osteophytosis, sclerosis or erosion. The presence of JE was checked whenever high signal intensity was observed in the articular space. The results evidenced the presence of bone changes in 30% of the sample. Osteophytes and erosions were the changes most commonly observed. JE was reported in 10% of TMJs. The results from the statistical tests revealed that bone changes in the head of the mandible are associated with the presence of JE.

Juvenile idiopathic arthritis with involvement of the temporomandibular joint: the role of image examinations

OBJETIVO: A artrite idiopatica juvenil (AIJ) tem etiologia desconhecida e o envolvimento da articulacao temporomandibular (ATM) e raro no estagio inicial da doenca. Este artigo descreve o uso de imagens de tomografia computadorizada (TC) e de ressonância magnetica (RM) para o diagnostico de ATM afetada pela AIJ. DESCRICAO DO CASO: Uma paciente de 12 anos de idade, leucoderma, portadora de AIJ com envolvimento de multiplas articulacoes foi encaminhada ao Centro de Imaginologia para avaliacao das ATMs. A paciente relatou dor na ATM e limitacao de abertura bucal. O exame com TC helicoidal da regiao da ATM com reconstrucoes a 1 mm mostrou assimetria entre os condilos mandibulares, erosao do condilo direito e formacao osteofitica. O exame de RM mostrou erosao do condilo mandibular direito, osteofito, deslocamento sem reducao e ruptura do disco articular. CONCLUSAO: As desordens de ATM devido a AIJ devem ser cuidadosamente examinadas por modernas tecnicas de imagem. A TC e muito util para a deteccao e avaliacao de estruturas osseas da ATM e permite o exame de alteracoes osseas discretas, que nao seriam identificadas por radiografias convencionais nas fases iniciais de AIJ. A RM permite a avaliacao de tecidos moles, identificacao de inflamacao articular aguda e diferenciacao entre hipertrofia sinovial e do pannus.