Editing Temporomandibular joint dysfunction (section)

==== Ultrasound ====
Where internal TMJ disorders are concerned, [[ultrasound]] (US) imaging can be a useful alternative in assessing the position of the disc<ref name=":4">{{cite journal | vauthors = Landes CA, Goral WA, Sader R, Mack MG | title = 3-D sonography for diagnosis of disk dislocation of the temporomandibular joint compared with MRI | language = en | journal = Ultrasound in Medicine & Biology | volume = 32 | issue = 5 | pages = 633–9 | date = May 2006 | pmid = 16677922 | doi = 10.1016/j.ultrasmedbio.2006.02.1401 }}</ref><ref name=":5">{{cite journal | vauthors = Jank S, Zangerl A, Kloss FR, Laimer K, Missmann M, Schroeder D, Mur E | title = High resolution ultrasound investigation of the temporomandibular joint in patients with chronic polyarthritis | language = en | journal = International Journal of Oral and Maxillofacial Surgery | volume = 40 | issue = 1 | pages = 45–9 | date = January 2011 | pmid = 20961737 | doi = 10.1016/j.ijom.2010.09.001 }}</ref> While having significant diagnostic [[Sensitivity and specificity|sensitivity]], US has inadequate [[Sensitivity and specificity|specificity]] when identifying [[Osteoarthritis|osteoarthrosis]]. Moreover, it is not accurate enough for the diagnosis of cortical and [[Articular disk of the temporomandibular joint|articular disc]] morphology based on the findings done related to morphological alterations.<ref name=":6">{{cite journal | vauthors = Bas B, Yılmaz N, Gökce E, Akan H | title = Ultrasound assessment of increased capsular width in temporomandibular joint internal derangements: relationship with joint pain and magnetic resonance grading of joint effusion | language = en | journal = Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics | volume = 112 | issue = 1 | pages = 112–7 | date = July 2011 | pmid = 21543241 | doi = 10.1016/j.tripleo.2011.02.020 }}</ref> However, with US, identification of [[effusion]] in individuals with inflammatory conditions associated with pain is possible and confirmed by MRI<ref name=":5" /><ref name=":6" /><ref name=":8" />

US can be a useful alternative in initial investigation of internal TMJ dysfunctions especially in MRI contraindicated individuals<ref name=":7"/> despite its limitations.<ref name="pmid18805233"/><ref name=":5" /> in addition to being less costly,<ref name=":8" /> US provides a quick and comfortable real-time imaging without exposing the individual to ionizing radiation<ref name=":4" /><ref name=":5" /><ref name=":6" />

US is commonly assessed in the differential diagnosis of alterations of glandular and neighbouring structures, such as the TMJ and the [[masseter muscle]]. Symptoms of sialendenitis and sialothiasis cases can be confused with [[Eagle syndrome]], TMD, myofascial and nerve pain, and other pain of the orofacial region.<ref name=":7" />

US assessment is also indicated where there is need to identify the correct position of the joint spaces for infiltrative procedures, [[arthrocentesis]], and [[viscosupplementation]]. This is due to the fact that US provides a dynamic and real-time location of the component of the joints, while providing adequate lubrication and washing, which can be confirmed by the joint space increase post-treatment.<ref>{{cite journal | vauthors = Dayisoylu EH, Cifci E, Uckan S | title = Ultrasound-guided arthrocentesis of the temporomandibular joint | language = en | journal = The British Journal of Oral & Maxillofacial Surgery | volume = 51 | issue = 7 | pages = 667–8 | date = October 2013 | pmid = 23769713 | doi = 10.1016/j.bjoms.2013.05.144 | url = https://www.bjoms.com/article/S0266-4356(13)00312-4/abstract }}</ref>