Exploring the relationship between clinical symptoms and MRI findings in temporomandibular joint disorders: a preliminary study

Background: This study aimed to evaluate the relationships between magnetic resonance imaging (MRI) findings (such as condylar degeneration, disc displace-ment, joint effusion and disc deformity) and clinical symptoms in patients with temporomandibular joint disorders (TMDs). Methods: A total of 54 patients (108 temporomandibular joints (TMJs)) were included. Clinical evaluations assessed joint pain, joint sounds, mouth opening limitations, deviation/deflection and locking. MRI scans were analyzed for condylar degeneration, disc displacement (disc displacement with reduction (DDWR) or disc displacement without reduction (DDWOR)), joint effusion, and disc morphology. Statistical analyses included chi-square tests/Fisher’s exact tests for categorical variables. A p value < 0.05 was considered to be statistically significant. Results: DDWR and DDWOR were significantly associated with joint pain (p = 0.044) and sounds (p = 0.032). Joint effusion demonstrated no clear correlation with clinical symptoms. Condylar degeneration was frequently observed but had limited clinical impact, except for a reduction in joint sounds (p = 0.03). Moreover, disc deformity was significantly correlated with condylar degeneration and joint effusion (p < 0.001). Conclusions: MRI findings provide valuable insights into the structural changes observed in TMDs. Although disc displacement is strongly linked to pain and joint sounds, condylar degeneration and effusion exhibit more complex relationships with clinical symptoms.

Temporomandibular joint disorder (TMD); Magnetic resonance imaging (MRI); Joint effusion; Disc deformity

[1] Goodfred J, Simon L, Azam A. Temporomandibular junction disorders. Primary Care. 2025; 52: 157–170.

[2] Eric M, Joli D, Russell S. Temporomandibular disorders: rapid evidence review. American Family Physician. 2023; 107: 52–58.

[3] Liu SS, Xu LL, Lu SJ, Mao MY, Liu LK, Cai B. Diagnostic performance of magnetic resonance imaging for degenerative temporomandibular joint disease. Journal of Oral Rehabilitation. 2023; 50: 24–30.

[4] Cha S, Lee SM, Wang J, Zhao Q, Bai D. Enhanced circadian clock in MSCs-Based cytotherapy ameliorates age-related temporomandibular joint condyle degeneration. International Journal of Molecular Sciences. 2021; 22: 10632.

[5] Bertram S, Rudisch A, Innerhofer K, Pümpel E, Grubwieser G, Emshoff R. Diagnosing TMJ internal derangement and osteoarthritis with magnetic resonance imaging. Journal of the American Dental Association. 2001; 132:753–761.

[6] Emshoff R, Innerhofer K, Rudisch A, Bertram S. The biological concept of “internal derangement and osteoarthrosis”: a diagnostic approach in patients with temporomandibular joint pain? Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology. 2002; 93: 39–44.

[7] Emshoff R, Brandimaier I, Bertram S, Rudisch A. Magnetic resonance imaging findings of osteoarthrosis and effusion in patients with unilateral temporomandibular joint pain. International Journal of Oral and Maxillofacial Surgery. 2002; 31: 598–602.

[8] Honda K, Natsumi Y, Urade M. Correlation between MRI evidence of degenerative condylar surface changes, induction of articular disc displacement and pathological joint sounds in the temporomandibular joint. Gerodontology. 2008; 25: 251–257.

[9] Li C, Chen B, Zhang R, Zhang Q. Comparative study of clinical and MRI features of TMD patients with or without joint effusion: a retrospective study. BMC Oral Health. 2024; 24: 314.

[10] Vogl TJ, Lauer HC, Lehnert T, Naguib NNN, Ottl P, Filmann N, et al. The value of MRI in patients with temporomandibular joint dysfunction: correlation of MRI and clinical findings. European Journal of Radiology. 2016; 85: 714–719.

[11] Güler N, Yatmaz PI, Ataoglu H, Emlik D, Uckan S. Temporomandibular internal derangement: correlation of MRI findings with clinical symptoms of pain and joint sounds in patients with bruxing behaviour. Dentomaxillofacial Radiology. 2003; 32: 304–310.

[12] Matsubara R, Yanagi Y, Oki K, Hisatomi M, Santos KC, Bamgbose BO, et al. Assessment of MRI findings and clinical symptoms in patients with temporomandibular joint disorders. Dentomaxillofacial Radiology. 2018; 47: 20170412.

[13] Maracci L, Savegnago G, Antoniazzi R, Marqueazan M, Silva T, Liedke G. Influence of examiner calibration on clinical and MRI diagnosis of temporomandibular joint disc displacement: a systematic review and meta-analysis. Dentomaxillofacial Radiology. 2024; 53: 341–353.

[14] Topaloglu Yasan G, Adiloglu S, Tuz HH, Sahar D. Evaluation of clinical signs and magnetic resonance imaging findings in patients with temporomandibular disorders. Journal of Cranio-Maxillofacial Surgery. 2023; 51: 441–447.

[15] Hosgor H. The relationship between temporomandibular joint effusion and pain in patients with internal derangement. Journal of Cranio-Maxillofacial Surgery. 2019; 47: 940–944.

[16] Mizuhashi F, Ogura I, Mizuhashi R, Watarai Y, Oohashi M, Suzuki T, et al. Examination for the factors involving to joint effusion in patients with temporomandibular disorders using magnetic resonance imaging. Journal of Imaging. 2023; 9: 101.

[17] Roh HS, Kim W, Kim YK, Lee JY. Relationships between disk displacement, joint effusion, and degenerative changes of the TMJ in TMD patients based on MRI findings. Journal of Cranio-Maxillofacial Surgery. 2012; 40: 283–286.

[18] Mizuhashi F, Ogura I, Mizuhashi R, Watarai Y, Oohashi M, Suzuki T, et al. Examination of joint effusion magnetic resonance imaging of patients with temporomandibular disorders with disc displacement. Journal of Imaging. 2024; 10: 241.

[19] Westesson PL, Brooks SL. Temporomandibular joint: relationship between MR evidence of effusion and the presence of pain and disk displacement. American Journal of Roentgenology. 1992; 159: 559–563.

[20] Balel Y, Yildiz S, Gokce E, Tumer M, Ege B. Does temporomandibular joint magnetic resonance imaging diagnosis support clinical examination diagnosis following diagnostic criteria for temporomandibular disorders? International Journal of Oral and Maxillofacial Surgery. 2023; 81: 813–819.

[21] Singer SR, Mupparapu M. Temporomandibular joint imaging. Dental Clinics of North America. 2023; 67: 227–241.

[22] Dias G, Grossmann E, Carvalho A, Devito K, Dos Santos M, Ferreira L. MRI changes and clinical characteristics in temporomandibular joints with displacement of the articular disk without reduction—a cross-sectional observational study. CRANIO®. 2025; 43: 521–530.

[23] Schiffman E, Ohrbach R, Truelove E, Look J, Anderson G, Goulet JP, et al. Diagnostic criteria for temporomandibular disorders (DC/TMD) for clinical and research applications: Recommendations of the International RDC/TMD Consortium Network* and Orofacial Pain Special Interest Group†. Journal of Oral & Facial Pain and Headache. 2014; 28: 6–27.

[24] Balel Y, Yildiz S, Gokce E, Tumer MK, Ege B. Does temporomandibular joint magnetic resonance imaging diagnosis support clinical examination diagnosis following diagnostic criteria for temporomandibular disorders? Journal of Oral and Maxillofacial Surgery. 2023; 81: 813–819.

[25] Arayasantiparb R, Tsuchimochi M, Mitrirattanakul S. Transformation of temporomandibular joint disc configuration in internal derangement patients using magnetic resonance imaging. Oral Science International. 2012; 9: 43–48.