Correlation of magnetic resonance imaging grades with cytokine levels of synovial fluid of patients with temporomandibular joint disorders: a cross-sectional study
- 15 Downloads
Magnetic resonance imaging (MRI) is a standardized method for assisting joint diagnosis. To validate the reliability of different imaging-based grading systems, this study examined (1) the associations between grading systems for osseous change, joint effusion, and the Wilkes classification of temporomandibular joint (TMJ) disorders and (2) the correlation between cytokines in synovial fluid and imaging-based joint scores.
Materials and methods
Twenty-seven patients, who routinely received numeric rating scale (NRS) and MRI assessment before TMJ arthrocentesis, were enrolled. Each joint was evaluated through the grading criteria for severity of osseous change and joint effusion by blinded observers using MRI. ImageJ was employed for classifying joint effusion. Joint synovial fluid, collected through arthrocentesis, was examined for cytokine expression by using a Luminex multiplex assay. All data were analyzed using the Pearson correlation analysis.
The Wilkes classification was strongly correlated with osseous change scores, but not with joint effusion scores. Joint effusion scores significantly correlated with NRS scores, but not with the Wilkes classification and osseous change scores. Compared with osseous change scores, joint effusion scores had a higher correlation with the levels of inflammatory cytokines (interleukin (IL)-8 and soluble IL-6 receptor (sIL-6R)) and with anti-inflammatory cytokines (soluble tumor necrosis factor receptors I and II (sTNF-RI/II)).
In patients with TMJ disorders, MRI grades are strongly correlated with NRS scores and levels of cytokines (IL-8, sIL-6R, and sTNF-RI/II) in the synovial fluid.
Joint effusion scoring can be a reliable and valid indicator for pathological assessment of TMJ disorders.
KeywordsTemporomandibular joint Magnetic resonance imaging Cytokines Joint effusion
This research was supported by a grant from the Ministry of Science and Technology, Taiwan (MOST105-2314-B-010-031-MY2).
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflicts of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
- 4.Shahidi S, Salehi P, Abedi P, Dehbozorgi M, Hamedani S, Berahman N (2018) Comparison of the bony changes of TMJ in patients with and without TMD complaints using CBCT. J Dent (Shiraz) 19:142–149Google Scholar
- 9.Ahmad M, Hollender L, Anderson Q, Kartha K, Ohrbach R, Truelove EL, John MT, Schiffman EL (2009) Research diagnostic criteria for temporomandibular disorders (RDC/TMD): development of image analysis criteria and examiner reliability for image analysis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 107:844–860CrossRefGoogle Scholar
- 11.Vangsness CT Jr, Burke WS, Narvy SJ, MacPhee RD, Fedenko AN (2011) Human knee synovial fluid cytokines correlated with grade of knee osteoarthritis—a pilot study. Bull NYU Hosp Jt Dis 69:122–127Google Scholar
- 15.MIG Campos PC, SRP Line (2006) Inflammatory cytokines activity in temporomandibular joint disorders: a review of literature. Braz J Oral Sci 5:1054–1062Google Scholar
- 20.De Riu G, Stimolo M, Meloni SM et al (2013) Arthrocentesis and temporomandibular joint disorders: clinical and radiological results of a prospective study. Int J Dent 2013:790648Google Scholar
- 21.Paniagua B, Pascal L, Prieto J, et al (2017) Diagnostic index: an open-source tool to classify TMJ OA condyles. Proc SPIE Int Soc Opt Eng 10137. https://doi.org/10.1117/12.2254070
- 27.Segami N, Nishimura M, Kaneyama K, Miyamaru M, Sato J, Murakami KI (2001) Does joint effusion on T2 magnetic resonance images reflect synovitis? Comparison of arthroscopic findings in internal derangements of the temporomandibular joint. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 92:341–345CrossRefGoogle Scholar
- 29.Nogami S, Takahashi T, Ariyoshi W, Yoshiga D, Morimoto Y, Yamauchi K (2013) Increased levels of interleukin-6 in synovial lavage fluid from patients with mandibular condyle fractures: correlation with magnetic resonance evidence of joint effusion. J Oral Maxillofac Surg 71:1050–1058CrossRefGoogle Scholar
- 34.Kaneyama K, Segami N, Sun W, Sato J, Fujimura K (2005) Analysis of tumor necrosis factor-alpha, interleukin-6, interleukin-1beta, soluble tumor necrosis factor receptors I and II, interleukin-6 soluble receptor, interleukin-1 soluble receptor type II, interleukin-1 receptor antagonist, and protein in the synovial fluid of patients with temporomandibular joint disorders. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 99:276–284CrossRefGoogle Scholar
- 39.Walker HK, Hall WD, Hurst JW (1990) Clinical methods: the history, physical, and laboratory examinations, 3rd edn. Butterworths, BostonGoogle Scholar