Makejev V. F., Kucher A. R., Rybert J. O., Zhyznomyrska O. O., Filipskiy A. V.

ULRTASONOGRAPHY IN OSTEOARTHRITIS OF THE TEMPOROMANDIBULAR JOINT


About the author:

Makejev V. F., Kucher A. R., Rybert J. O., Zhyznomyrska O. O., Filipskiy A. V.

Heading:

CONTENTS

Type of article:

Scentific article

Annotation:

Introduction. Osteoarthritis of the temporomandibular joint (TMJ) is the cause of reduced quality of life for patients. Structural changes in the TMJ osteoarthritis characterized by damage to the articular disc, the ap-pearance of bony osteophytes, chronic synovitis, thickening of the joint capsule. Practically use of ultrasonography (USG) is unexplored in the diagnosis of TMJ osteoarthritis. Purpose. To investigate the possibility of USG in the diagnosis of TMJ osteoarthritis. Methods. group of TMJ osteoarthritis included 14 patients (23 joints). Control group consisted of 29 healthy volunteers with no clinical signs of TMJ pathology. For all patients made such examination like ortopantomogramma, USG and MSRKT. With USG evaluated the mandiblular head (MH), capsule – condylar space (CCS), articular disc (AD) bilaminar zone, joint capsule, lateral pterygoid muscle (LPM). Also performing functional tests to assess range motion of MH and location of AD and its relation to localization of MH. Results. Determined specific ultrasonographic criteria of TMJ osteoarthritis. With USG in 90. 5% of cases (19 joints) we found the osteophytes on the surface of MH In 95. 2% of cases (20 joints) determined thinning of subchondral-cartilage complex. In 80. 9% of cases (17 joints) was found reduce size of CCS in horizontal slice: in the control group – 1,45±0,16 mm; in the experimental group 1,04±0,22 m. In sagital slice: in the control group – 1,4±0,32 mm; in the experimental group 0,85±0,16 mm. In 14. 3% of cases(3 joints) in the presence of joint synovitis, determined increase size of CCS. Measurements of AD in horizontal slices: in the control group were 1,25±0,16 mm; in the experimental group 0,92±0,34 mm. In sagital slices: in the control group – 1,46±0,32 mm; in the experimental group 1,28±0. 46 mm. In 57. 1% of cases (12 joints) we found forward displacement of AD. In 76. 2% of cases (16 joints) echogenicity of AD was increased. In 71. 4% of cases (15 joints) echostrukture AD was patchy. In patients with TMJ osteoarthritis observed reduction of size bilaminar area: in the control group – its length varied in the range 4,34±0,32 mm, width – 1,24±0,18 mm in the experimental group, respectively – length 3,94±0,76 mm; width – 0,94±0,55 mm. In most cases – 18 joints (85. 7%) echogenicity of bilaminar zone was increased. Only 2 joints (9. 5%) bilaminar zone was with little signs of heterogeneity. The thickness of the joint capsule in patients with osteoarthritis was higher contrary to the thickness in the control group: horizontal slices in the control group 0,75±0,37 mm; in the experimental group 1,34±0,42 mm. Frontal slices: in the control group – 0. 82±0,26 mm; in the experimental group 1,28±0,46 mm. In patients of the main group detected increased vertical size of LPM in compare to the control group : control group – 12,85±1,65 mm, experimental group – 15,46±2,32 mm. The purpose of performing functional tests were monitoring the movement of MH and AD when patient opens and closes his mouth. In the control group, the movement trajectory of MH was smooth : forward and down when opens the mouth; back and up when closes the mouth. The range of MH movement in the control group ranged from 7. 5 mm to 15. 8 mm. In the experimental group: in 16 joints (76. 2%) the MH amplitude of the motion is not exceed 5mm; in 5 joints (23. 8%) was found hypermobility. In 85. 7% of cases (18 joints) observed no synchronous movement MH and AD. In 4 joints (19. 0%) AD visualization was not achieved at all. Coclusion. Problem TMJ osteoarthritis take one of the main places in clinical rheumatology and dentistry. USG method can be used to diagnose TMJ osteoarthritis how much more accessible, cheaper and safer.

Tags:

temporomandibular joint, ultrasonography, osteoarthritis

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Publication of the article:

«Bulletin of problems biology and medicine» Issue 2 part 1 (107), 2014 year, 228-232 pages, index UDK 616. 724-002-073. 48