Nucl Med Mol Imaging.  2016 Sep;50(3):213-218. 10.1007/s13139-016-0407-z.

Open-Mouth Bone Scintigraphy Is Better than Closed-Mouth Bone Scintigraphy in the Diagnosis of Temporomandibular Osteoarthritis

• Park KS
• Song HC
• Cho SG
• Kang SR
• Kim J
• Jun HM
• Song M
• Jeong GC
• Park HJ
• Kwon SY
• Min JJ
• Bom HH

• KMID: 2351645
• DOI: http://doi.org/10.1007/s13139-016-0407-z

Abstract

PURPOSE
Closed-mouth bone scintigraphy (CM scan) and closed-mouth single-photon emission computed tomography (CM SPECT) are used for conventional evaluation of osteoarthritis of the temporomandibular joint (TMJ). However, the adequacy of open-mouth bone scintigraphy (OMscan) has not yet been evaluated. Therefore, the purpose of this study was to compare the diagnostic performance of CMscan,CMSPECT, and OM scan.
METHODS
Thirty-six patients with suspicion of an abnormality of the TMJ and who underwent a (99m)Tc-HDP CM scan, CM SPECT, and an OM scan were enrolled. The scans were assessed visually for the presence of positive focal uptake in the TMJ. Osteoarthritis was defined as arthralgia plus crepitus or radiologic signs of arthrosis.
RESULTS
Of 72 TMJs, 21 (29.2 %) were diagnosed with osteoarthritis. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy were 90.5 %, 49.0 %, 42.2 %, 92.6 % and 61.1 % for the CM scan, 81.0 %, 58.8 %, 44.7 %, 88.2 % and 65.3 % for CM SPECT, and 81.0 %, 82.4 %, 65.4 %, 91.3 % and 81.9 % for the OM scan, respectively. The accuracy of the OM scan was higher than that of CM SPECT and the CM scans (p=0.004 and p<0.001, respectively).
CONCLUSIONS
The OM scan was more accurate than the conventional CM scan and even CM SPECT for diagnosing TMJ osteoarthritis.

Keyword

Open mouth; Temporomandibular joint; Osteoarthritis; Bone scintigraphy; Bone scan

MeSH Terms

Arthralgia
Diagnosis*
Humans
Osteoarthritis*
Radionuclide Imaging*
Sensitivity and Specificity
Temporomandibular Joint
Tomography, Emission-Computed
Tomography, Emission-Computed, Single-Photon