Abstract |
Temporomandibular (TM) joint pain results from many
etiologic factors. The aim of this study was to
evaluate the utility of Bone SPECT in patients with TM
joint pain. The subjects were 34 patients with TM joint
pain. All patients underwent plain radiography, planar
bone scan, and Bone SPECT. The intensity of
radioisotope uptake at TM joint was graded into three;
no increased uptake above three background activity as
grade 0, uptake similar to occipital bone as grade I,
and uptake similar to maxillary sinus as grade II.
Clinical findings and therapeutic methods were
reviewed. Twenty-seven patients (80%) out of 34
patients with TM joint pain had increased uptake in
bone SPECT. Twenty-one (78%) out of 27 patients had
increased uptake in the mandibular condyle and
remaining six patients (22%) had uptake in the
mandibular and maxillary arch, which proved to be
dental problem. Seven patients out of 34 were grade as
0, four (12%) were grade I, 23 (68%) were grade II.
Four patients with grade I had clicking sound and
symptoms which were subsided with medication in all
cases. Among 23 patients with grade II, 7 patients had
clicking sound and 14 patients underwent medication and
decompression therapy. With Planar bone scan, 11 cases
(32%) had increased uptake in TM joint area. Plain
radiography revealed narrowing, distension, erosion and
limitation of TM joint in 16 cases (47%). Bone SPECT
can be valuable for screening and managing the patients
with TM joint pain. Patients with grade II needed
intensive treatment such as joint aspiration. However
degree of the radioisotope uptake did not well
correlated with clinical symptoms. |