Plain Film Arthrography Applied to the Diagnosis of Intra-Articular Adhesions of the Temporomandibular Joint
Purpose
To evaluate the diagnostic accuracy of plain film arthrography (PFA) on the presence of intra-articular adhesions of the temporomandibular joint (TMJ).
Patients and Methods
The study population included 105 consecutive patients (105 TMJs) and data collected in our department. All patients were examined by PFA and arthroscopy. The findings of interpreting PFA were recorded as positive, suspicious, or negative according to the PFA radiographic criteria. After comparing the findings of PFA with those of arthroscopy, the comparison data were assessed by generating receiver operating characteristic curve (ROC curve) and analyzing the area (A(z)) under the curves with SPSS 11.0 (SPSS, Inc, Chicago, IL), and the area under the ROC curve was calculated. According to the area, the diagnostic value of PFA was evaluated. Meanwhile, the causes of misdiagnosis and underdiagnosis of intra-articular adhesions were analyzed.
Results
Arthroscopic surgery results confirmed that 56 TMJs in 105 patients had adhesions. The area under ROC curve was 0.73 (confidence interval, 0.64, 0.82; P < .05). The adhesions located in the medial groove could hardly be detected through PFA, while those located in the lateral two thirds of upper joint compartment could easily be detected.
Conclusion
Although the diagnostic accuracy of PFA was fair, it was a simple and effective modality to diagnose intra-articular adhesions of the TMJ. The causes of misdiagnosis and underdiagnosis were related to the size and location of the intra-articular adhesions.
⁎Attending Doctor, Department of Oral and Maxillofacial Surgery, Ninth People’s Hospital, Shanghai Second Medical University, People’s Republic of China.
†Professor, Department of Oral and Maxillofacial Surgery, Ninth People’s Hospital, Shanghai Second Medical University, People’s Republic of China.
‡Associate Professor, Department of Oral and Maxillofacial Surgery, Ninth People’s Hospital, Shanghai Second Medical University, People’s Republic of China.
§Professor, Department of Oral and Maxillofacial Surgery, Ninth People’s Hospital, Shanghai Second Medical University, People’s Republic of China.
∥Professor, Department of Radiography, Ninth People’s Hospital, Shanghai Second Medical University, People’s Republic of China.
Address correspondence and reprint requests to Dr Yang: Department of Oral and Maxillofacial Surgery, Ninth People’s Hospital, Shanghai Second Medical University, No. 639, Zhi Zao Ju Road, 200011, Shanghai, People’s Republic of China
This study was supported by a grant of Shanghai Leading Academic Discipline fund (Y0203), and a grant from Shanghai Municipal Bureau of Public Health (No. 01464).
ABSTRACT