Diagnostic Value of Ultrasonography in Temporomandibular Disorders

Purpose: The purpose of this study was to determine the diagnostic value of ultrasonographic imaging (USI) in temporomandibular disorders. Patients and Methods: USI and magnetic resonance imaging (MM) were performed in 182 temporomandibular joints (TMJs) of 91 patients who were referred for treatment. After a detailed clinical examination, patients who were clinically diagnosed with TMJ disc derangement were referred to the radiology department for MRI and USI examinations. US! and MRI diagnoses of disc displacement were compared, using clinical diagnosis as the golden standard. The overall agreement between USI and MRI results was evaluated. Results: Compared with the clinical diagnosis, MRI showed a sensitivity of 85%, specificity of 62%, and an accuracy of 80% in the detection of internal derangements. The positive predictable value, negative predictive value, and likelihood ratio were 88%, 54%, and 2.29, respectively. Compared with the clinical diagnosis, USI showed a sensitivity of 69%, specificity of 80%, and accuracy of 71% in the detection of internal derangements. The positive predictable value, negative predictive value, and likelihood ratio were 92%, 42%, and 3.45, respectively. Comparing the agreements between the MRI and USI diagnoses of internal derangement, the kappa value was found to be 0.36, indicating poor reliability (P < .001). Conclusion: USI, a noninvasive and dynamic imaging method, is a reliable method in evaluating the position of the disc in TMJ disc derangements. Better visualization of joint structures and more reliable results with higher sensitivity and accuracy can be achieved with high-resolution devices (>= 12 MHz). (C) 2011 American Association of Oral and Maxillofacial Surgeons J Oral Maxillofac Surg 69:1304-1310, 2011