Correlation between clinical and magnetic resonance imaging (MRI) findings in temporomandibular disorders

This study was carried out to determine the value of Magnetic resonance imaging (MRI) as a diagnostic tool in patients with temporomandibular disorders. The clinical presentation and MRI findings on 88 temporomandibular joints belonging to 44 symptomatic patients were retrospectively studied. The disk position, configuration and signal intensity; mandibular condyle morphology and signal intensity; temporomandibular joint space and surrounding soft tissue abnormality were assessed. The correlation between the clinical and MRI findings was statistically analyzed using Fisher's exact (1-sided) test. Pain in the temporomandibular region was the most common clinical presentation, it accounts for 64% of cases. There was significant correlation between pain, and disc displacement with no reduction (DDWNR) and condylar hyperlaxity (p = 0.04, 0.03, respectively), as well as between clicking and each type of DD (p = 0.00). Statistically significant relationship was also found between tenderness, and DDWNR and presence of joint effusion (p = 0.02, 0.03, respectively) as well as between limitation of mouth opening and condylar marrow edema (p = 0.02). Causes of temporomandibular disorders can be well defined by clinical examination. However, MRI can be preserved for patients with pain in whom an initial medical conservative oral treatment failed in order to exclude other pathological process

Rupture of De Novo Middle Cerebral Artery Aneurysm 8 Years After the Clipping of Ruptured M1 Middle Cerebral Artery Aneurysm.

BACKGROUND Development and rupture of a de novo intracranial aneurysm is rare. Little is known regarding its etiology and the appropriate timing of follow-up angiograms after surgical clipping or coiling. CASE REPORT We present a case report of a 39-year-old male smoker with history of hypertension who developed a de novo aneurysm 8 years after surgical clipping of an aneurysm in the middle cerebral artery in the same segment. He presented with neck rigidity and drowsiness. Laboratory analysis did not show blood dyscrasia. Brain computerized tomography showed right temporal lobe hematoma and 4-vessel angiogram demonstrated de novo aneurysm in the same segment of the M1 middle cerebral artery, which was confirmed by intraoperative microsurgical findings. We review the literature on such cases and discuss the pathophysiology, diagnosis, and treatment of this condition. De novo aneurysm, although rare, can develop within days to as long as 10 years after surgical clipping or coiling. CONCLUSIONS This rare case of de novo aneurysm supports follow-up imaging of patients after initial surgical clipping for up to 10 years