Ultrasound assessment of temporomandibular disorders: a retrospective cross-sectional study in a tertiary referral center

Background: This study aimed to characterize ultrasonographic findings in patients referred to a tertiary center for temporomandibular disorders (TMDs), assess their associations with TMD diagnoses, compare symptomatic and contralateral temporo-mandibular joints (TMJs), and describe the demographic and clinical characteristics of this population. Methods: This retrospective cross-sectional study included 108 symptomatic patients referred between October 2020 and March 2026. Diagnoses were established according to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD Axis I). Standardized clinical examination and bilateral high-frequency ultrasonography assessed capsular thickness, joint effusion, disc visibility, condylar translation, and popping-like movements using static and dynamic maneuvers. Within-patient comparisons and exploratory subgroup analyses were performed. Results: Patients were predominantly female (81.5%), with a mean age of 48.6 years and a median symptom duration of 5 years. The most common primary diagnoses were degenerative joint disease (45.4%), muscular disorders (13.9%), and reducible disc displacement (13.9%); 30% had concomitant diagnoses. Compared with contralateral joints, symptomatic TMJs showed greater longitudinal capsular thickness (median 1.68 mm (IQR 1.30) vs. 1.47 mm (IQR 0.60); p = 0.047), more frequent effusion (longitudinal: 17.6% vs. 0.9%, p < 0.001; transverse: 16.7% vs. 1.9%, p = 0.011), greater disc visibility (29.6% vs. 14.8%, p = 0.021), and more abnormal condylar translation (20.4% vs. 11.1%, p = 0.021). Transverse disc visibility and visibility at maximal opening were associated with disc displacement disorders (both p < 0.001). Effusion was more frequent in degenerative and inflammatory joint diseases (p = 0.030 and p = 0.044 during dynamic maneuvers, respectively). Ultrasonography identified displacement in 73.9% (17/23) of magnetic resonance imaging (MRI)-confirmed cases. Conclusions: Ultrasonographic findings were associated with symptomatic TMJs and specific diagnostic subgroups, particularly disc visibility in disc displacement disorders and effusion in inflammatory and degenerative intra-articular conditions. Ultrasonography may provide complementary information alongside clinical assessment and MRI.

Temporomandibular joint; Temporomandibular disorders; Ultrasonography; Disc displacement; Joint effusion; Musculoskeletal ultrasound

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