Relationship between Unilateral Temporomandibular Joint Arthralgia and Disc Positions and Degenerative Joint Changes- A Cross Sectional Study

Abstract

Background: This study simultaneously assessed for both temporomandibular joint (TMJ) disc displacement (DD) and degenerative joint disease (DJD) in participants with unilateral TMJ arthralgia using TMJ MRI and CBCT.Methods: In the multi-center TMJ Impact Project, 401 subjects were examined by calibrated examiners that included rendering a diagnosis of TMJ arthralgia. All subjects had bilateral TMJ MRIs and CTs. Two radiologists rendered a consensus diagnosis of normal, DD with reduction (DDwR), or DD without reduction (DDw/oR) using MRI. CBCT consensus diagnoses included normal or grade I DJD and grade II DJD. Radiologist reliability was assessed by kappa. Descriptive analysis was performed using generalized linear mixed models. Models include a random intercept to account for correlations within subject. The level of significance is p< 0.05. Results: Of the 401 subjects, 58 subjects had a clinical diagnosis of unilateral arthralgia. In 58 joints with arthralgia, 11(19%) had normal disc position, 19 (33%) had DDwR and 28 (48%) had DDw/oR compared to 58 joints without arthralgia: 13 (22%) were normal, 25 (43%) had DDwR and 20 (34%) had DDw/oR (p=0.32). In joints with arthralgia, 25 (43%) had normal osseous morphology and 33 (57%) had DJD compared to joints without arthralgia 32 (55%) had normal osseous morphology and 26 (44%) had DJD (p=0.20). Radiologist reliability was kappa: 0.73 (CI: 0.64–0.83) for DD and 0.76 (CI: 0.68-0.83) for DJD. Conclusion: The presence of arthralgia is not significantly related to the radiographic findings of DD and DJD.