How Does Capsular Distension Pain Manifest in Patients with Anterior Disc Dislocation with Reduction of Temporomandibular Joint?

Joint effusion (JE) refers to the presence of a pathological collection of fluid in the joint space, and JE is one of the symptoms of the inflammatory process in the temporomandibular joint (TMJ) and it is associated with the presence of TMJ pain. The authors of this study focused on the ultrasonographic evaluation of TMJ capsular distension, capsular width in patients with unilateral anterior disc dislocation. The cohort included 200 patients, 169 women and 31 men, with a mean age of 34.3 years (range 11–82 years). All patients were diagnosed with disc dislocation with reduction. 102 patients were completely pain free, 98 patients reported pain localized to the TMJ area. 28 patients perceived their pain as persistent in the last week before the examination, 70 patients perceived their pain as irregular. The results showed that capsular distension was demonstrably greater in patients with pain than in patients without pain. The increase in capsular distension is not affected by whether the pain is persistent or irregular. Capsular distension is enhanced in patients with TMJ palpation pain and painful dynamic testing. The authors confirm the use of ultrasonography as an ideal method for diagnosing JE. Also an association between the presence of JE and pain in patients with disc dislocation has been demonstrated. Painful lateral palpation and painful dynamic test are clinical signs of JE and thus signs of an intra articular inflammatory process in patients with TMJ pain.