The efficacy and limitations of USI for diagnosing TMJ internal derangements

  • Kader Azlağ PekinceEmail author
  • Fatma Çağlayan
  • Adem Pekince
Original Article



This study was conducted to determine the effectiveness of ultrasonographic imaging for diagnosing temporomandibular joint internal derangements.

Materials and methods

Ultrasonographic and magnetic resonance imaging scans of temporomandibular joints were obtained bilaterally in 55 patients who had temporomandibular joint disorders and who were diagnosed with temporomandibular joint internal derangements following a clinical examination. Diagnostic accuracy of ultrasonographic imaging was assessed considering magnetic resonance imaging as the gold standard method.


When the results of ultrasonographic imaging and magnetic resonance imaging were compared, the diagnostic accuracy of ultrasonographic imaging was 0.81 for detecting TMJ disc displacement. The diagnostic accuracy of ultrasonographic imaging in detecting TMJ disc position was 0.81 in the closed-mouth position and 0.93 in the open-mouth position.


As a noninvasive and reproducible imaging method acquiring dynamic images, ultrasonographic imaging is a successful method in the evaluation of temporomandibular joint disc displacement.


Temporomandibular joint Ultrasonographic imaging Magnetic resonance imaging Disc displacement with reduction Disc displacement without reduction 


Compliance with ethical standards

Conflict of interest

No conflict of interest

Ethical approval

Ethical committee approval was obtained from Atatürk University Faculty of Dentistry. Ethics committee approval was given by the ethics committee of the Faculty of Dentistry at Atatürk University by the decision dated 15.09.2015 and numbered 39.

Informed consent

Informed consent is signatured by people included in the study.


  1. 1.
    Dimitroulis G, Dolwick MF, Martinez A. Temporomandibular joint arthrocentesis and lavage for the treatment of closed lock: a follow-up study. Br J Oral Maxillofac Surg. 1995;33:23–6 (discussion 6–7).CrossRefGoogle Scholar
  2. 2.
    Frost DE, Kendell BD. The use of arthrocentesis for treatment of temporomandibular joint disorders. J Oral Maxil Surg. 1999;57:583–7.CrossRefGoogle Scholar
  3. 3.
    Gauer RL, Semidey MJ. Diagnosis and treatment of temporomandibular disorders. Am Fam Physi. 2015;91:378–86.Google Scholar
  4. 4.
    Katzberg RW, Westesson PL, Tallents RH, Drake CM. Anatomic disorders of the temporomandibular joint disc in asymptomatic subjects. J Oral Maxillofac Surg. 1996;54:147 – 53 (discussion 53 – 5).CrossRefGoogle Scholar
  5. 5.
    Katzberg RW, Westesson PL, Tallents RH, Drake CM. Orthodontics and temporomandibular joint internal derangement. Am J Orthod Dentofacial Orthop. 1996;109:515–20.CrossRefGoogle Scholar
  6. 6.
    Kundu H, Basavaraj P, Kote S, Singla A, Singh S. Assessment of TMJ disorders using ultrasonography as a diagnostic tool: a review. J Clin Diagn Res. 2013;7:3116–20.Google Scholar
  7. 7.
    Landes C, Walendzik H, Klein C. Sonography of the temporomandibular joint from 60 examinations and comparison with MRI and axiography. J Craniomaxillofac Surg. 2000;28:352–61.CrossRefGoogle Scholar
  8. 8.
    Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics. 1977;33:159–74.CrossRefGoogle Scholar
  9. 9.
    Laskin DM. TMDs an evidence base approach to diagnosis and treatment. In: Laskin DM, Greene CS, Hylander WL, editors. Internal derangements. Hanover Park: Quintessence Publishing Co; 2006. pp. 249–53.Google Scholar
  10. 10.
    Okeson JP. Management of temporomandibular disorders and occlusion. 6th ed. Philadelphia: Mosby Elsevier; 2008.Google Scholar
  11. 11.
    Okeson JP. Joint intracapsular disorders: diagnostic and nonsurgical management considerations. Dent Clin N Am. 2007;51:85–103. vi.CrossRefGoogle Scholar
  12. 12.
    Tasaki MM, Westesson PL, Isberg AM, Ren YF, Tallents RH. Classification and prevalence of temporomandibular joint disk displacement in patients and symptom-free volunteers. Am J Orthod Dentofac Orthop. 1996;109:249–62.CrossRefGoogle Scholar
  13. 13.
    Tasaki MM, Westesson PL. Temporomandibular joint diagnostic accuracy with sagittal and coronal MR imaging. Radiology. 1993;186:723–9.CrossRefGoogle Scholar
  14. 14.
    Uysal S, Kansu H, Akhan O, Kansu O. Comparison of ultrasonography with magnetic resonance imaging in the diagnosis of temporomandibular joint internal derangements: a preliminary investigation. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2002;94:115–21.CrossRefGoogle Scholar
  15. 15.
    Vogl TJ, Lauer HC, Lehnert T, Naguib NN, Ottl P, Filmann N, et al. The value of MRI in patients with temporomandibular joint dysfunction: correlation of MRI and clinical findings. Eur J Radiol. 2016;85:714–9.CrossRefGoogle Scholar
  16. 16.
    Wolford LM, Reiche-Fischel O, Mehra P. Changes in temporomandibular joint dysfunction after orthognathic surgery. J Oral Maxillofac Surg. 2003;61:655–60 (discussion 61)CrossRefGoogle Scholar
  17. 17.
    Westesson PL, Liedberg J. Horizontal condylar angle in relation to internal derangement of the temporomandibular joint. Oral Surg Oral Med Oral Pathol. 1987;64:391–4.CrossRefGoogle Scholar

Copyright information

© Japanese Society for Oral and Maxillofacial Radiology and Springer Nature Singapore Pte Ltd. 2019

Authors and Affiliations

  1. 1.Department of Oral Diagnosis and Radiology, Faculty of DentistryKarabük UniversityKarabükTurkey
  2. 2.Department of Oral Diagnosis and Radiology, Faculty of DentistryAtatürk UniversityErzurumTurkey

Personalised recommendations