Whiplash
and TMJ: MRI Documentation
The relationship between
whiplash injuries and temporomandibular joint pain (TMJ) has been receiving
more attention in the last few years. A new study adds to this body of knowledge,
by documenting joint abnormalities with MRI imaging.
In this study, researchers
performed MRI scans on 87 whiplash patients (174 joints) with TMJ pain. These
subjects had no direct trauma to the face in the accident and had no pre-accident
TMJ symptoms. The study found that, "Internal derangement was present in 143/164
(87%) of the TMJs. 118/164 (72%) demonstrated displacement with reduction (DDR),
and 25/164 (15%) demonstrated disk displacement without reduction (DDNR); only
21/164 (13%) of the TMJs were found to be normal."
The authors compared these
results to studies done on asymptomatic TMJs and found that the whiplash patients
were significantly more likely to have changes shown on MRI. "In fact, the cervical
whiplash patients in our group and similar groups were approximately two to
seven times more likely to demonstrate internal derangement (DDR or DDNR) than
were the asymptomatic/normal subjects."
The authors conclude, "We
can no longer overlook the jaw - MR imaging clearly demonstrates the relationship
between post MVA cervical whiplash and TMJ injuries. Based on the forgoing,
an examination of the TMJs for possible injuries should be an integral part
of any comprehensive evaluation of post MVA cervical whiplash patients."
Garcia R, Arrington JA.
The relationship between cervical whiplash and temporomandibular joint injuries:
an MRI study. The Journal of Craniomandibular Practice 1996;14(3):233-239.
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