Ultrasonography has acceptable diagnostic efficacy for detection of temporomandibular joint disc displacement

The Dental Elf, 2012

Ultrasonography has acceptable diagnostic efficacy for detection of temporomandibular joint disc displacement » The Dental Elf
Temporomandibular disorders (TMDs) result in craniofacial pain, limited mouth opening, temporomandibular joint (TMJ) clicks affecting the joint and related structures.  A prevalence of between 10% to 70% has been reported, and it particularly effects women aged 20 to 40 years.
TMDs can be classified into muscular disorders, internal derangement (ID), inflammatory disease, and osteoarthritis.
Internal derangement is common and can cause other TMDs.   Magnetic resonance imaging (MRI), computed tomography, arthrography, and ultrasonograpy are all used to image the TMJ.
The aim of this review was to assess and explore the reliability of ultrasonography in diagnosing the disc displacement of TMJ.
The Medline, Embase and the Chinese Biomedical Literature Databases were searched without language restriction.
Diagnostic test accuracy studies that evaluated use of ultrasonography for detecting TMJ disc displacement in patients with any symptoms or clinical signs related to a TMD were included.  Studies also needed to use of MRI as the gold standard and include sensitivity, specificity information with abnormal disc locations defined as ID.
 study inclusion, data extraction, and risk of bias assessment was performed by two authors in duplicate.
Fifteen studies (14 cohort studies, 1 case-control study) were included; 6 studies had a low risk of bias, 6 an unclear risk, and 3 a high risk.
 Meta-regression indicated that the detected results were not influenced by the types of ultrasonography, image dimensions, types of transducer, and ultrasonic image of the disc ( P > .05).
The Q* (the point where sensitivity equals specificity on the summary reviewer operator characteristics curve) values of ultrasonography for the closed- and open-mouth positions were 0.79 and 0.91, respectively.