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Review
. 2024 Sep 23;16(9):e70004.
doi: 10.7759/cureus.70004. eCollection 2024 Sep.

Ultrasound Elastography in Temporomandibular Disorders: A Narrative Review

Deepa J Patil  1 , Rajesh K Rathore  2 , Ashutosh Patel  2
Affiliations
Review

Ultrasound Elastography in Temporomandibular Disorders: A Narrative Review

Deepa J Patil et al. Cureus. .

Abstract

A class of intricate musculoskeletal diseases known as temporomandibular disorders (TMDs) affects the temporomandibular joint (TMJ) and its supporting structures. The majority of individuals will at some point in their lives experience some degree of TMD symptoms, as these diseases are highly prevalent in the general population. TMDs are multifactorial and are attributed to various physical and biopsychosocial factors. The TMD patients typically experience preauricular pain, tenderness of masticatory muscles, and joint sounds, and these in turn affect their quality of life. To carry out the appropriate course of treatment, it is critical to make an accurate and timely diagnosis. The TMDs are classified as myofascial pain, internal disc derangement, and degenerative disorders of TMJ. Myofascial pain, which is identified by palpating the affected muscles of mastication and tenderness, is one of the most common findings. The muscles in this condition become stiff due to the contraction of myofibrils and are known as trigger bands. The diagnosis of trigger bands involving the masticatory muscles commonly involving the masseter muscle in myofascial pain to date is subjective, and palpation is the only tool used for its diagnosis. An objective assessment of the masticatory muscles is desirable for accurate diagnosis and treatment planning. Various tools like electromyography and hardness meters have been for assessing muscle stiffness, but their application in TMJ muscle disorders has not yielded valuable results. A novel diagnostic method called ultrasound elastography evaluates muscle stiffness both qualitatively and quantitatively using an elastogram and the muscular elasticity index. In this paper, we will review the ultrasound elastographic techniques utilized for the diagnosis and management of TMDs.

Keywords: masseter; shear wave elastography; strain wave elastography; temporomandibular disorders; ultrasound elastography.

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Conflict of interest statement

Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Color-coded elastogram generated by strain wave elastography
Figure 2
Figure 2. Graph depicting the muscle elasticity index generated by ratio of elasticity index of masseter muscle with the surrounding subcutaneous tissue
Figure 3
Figure 3. Pictorial description of generation of shear wave by the ultrasound transducer
Image credits: Dr. Deepa J. Patil
Figure 4
Figure 4. Step-wise description of shear wave generation and calculation of elastic modulus
Image credits: Dr. Deepa J. Patil
See this image and copyright information in PMC

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