@article{oai:niigata-u.repo.nii.ac.jp:00025712,
 author = {範, 順涛 and 伊藤, 寿介 and 林, 孝文},
 issue = {1},
 journal = {新潟歯学会雑誌, 新潟歯学会雑誌},
 month = {Jul},
 note = {In order to clarify a possible cause of articular pain in patients with a unilateral non-reducible anterior disk displacement in the temporomandibular joint, MR images of 50 consecutive patients were evaluated. On fatsaturated T2-weighted sagittal images in closed mouth position, an edematous change of the posterior attachment was defined as the condition in which the thickened posterior attachment showed higher intensity tllan that of the contralateral side. Joint effusion was defined as the condition in which a hyperdense area at the upper and/or lower joint space was larger than linear in configuration. On proton-density weighted images in opened mouth position, a thrusting sign was defined as the condition in which the thickened posterior attachment has been stuck by the roughened surface of the mandibular condyle. A statistically significant correlation was observed between articular pain and an edematous change of the posterior attachment (P<0.001). Additionally, a statistically significant correlation was observed between articular pain and a thrusting sign (P<0.001). On the contrary, no statistically significant correlation was observed between articular pain and joint effusion (p=0.09). Every patient with a thrusting sign complained of articular pain. In conclusion, it was suggested that articular pain might be correlated with an edematous change of the posterior attachment. Moreover, a thrusting sign in opened mouth position might be a more specific finding closely related to articular pain., 顎関節に非復位性関節円板前方転位(以下ADNR)を有する症例における開口時の関節痛(以下開口痛)の原因を明らかにするために、片側のみにADNRを有する50症例のMR所見をretrospectiveに検討した。閉口位矢状断脂肪抑制T2強調画像において、ADNR側の後部組織が健側と比較し明らかに肥厚し高信号を呈する場合に、浮腫を認めると判定した｡また上関節腔あるいは下関節腔に線状を越えた高信号域を有する場合にjoint effusionを認めると判定した｡さらに開口位矢状断プロトン密度強調画像において、肥厚した後部組織に辺縁の不整化した下顎頭関節面が突き当たるような位置関係にある場合、thrusting signを認めると判定した｡その結果、後部組織の浮腫の有無と開口痛の有無、及びthrusting signの有無と開口痛の有無との間に統計学的に有意な関係を認めた(P<0.001)が、joint effusionの有無と開口痛の有無との間には認められなかった(p=0.09)。thrusting signを認める症例は全て開口痛を有していた｡以上の結果から、開口痛の原因のひとつに後部組織の浮腫があることが示唆された｡さらに、肥厚した後部組織に辺縁の不整化した下顎頭が突き当たるという位置関係は開口痛に特異的な所見となりうると考えられた。},
 pages = {11--15},
 title = {非復位性関節円板前方転位を有する症例における開口痛とＭＲ所見との関係 : 脂肪抑制Ｔ2強調画像における後部組織の浮腫とjoint effusionについて},
 volume = {32},
 year = {2002}
}