Comparison of Medic and 3d Dess with Routine MRI to Assess the Diagnostic Efficacy in Symptomatic Temporomandibular Disorders – A Cross Sectional Observational Study

Background: Temporomandibular disorders (TMDs) affect the orofacial region, particularly the temporomandibular joint (TMJ). This study evaluated early intra-articular disc changes in symptomatic TMD patients using various MRI sequences, comparing the diagnostic efficacy of MEDIC and 3D DESS with routine MRI. Materials and Methods: A total of 108 TMJs from symptomatic patients were assessed. All underwent routine MRI, MEDIC, and 3D DESS sequences. Three radiologists qualitatively and quantitatively evaluated images using Likert’s scale. Statistical analysis was performed with SPSS, and inter-observer variability assessed via Fleiss' kappa (κ). Results: MRI revealed 41.7% disc displacement with reduction, 19.4% without reduction, and 38.9% normal. MEDIC provided superior visualization of joint fluid and bone marrow changes, followed by PD-FSE and DESS. Signal intensity ratios were highest in PD-FSE, followed by MEDIC and DESS. Inter-observer reliability showed perfect agreement. Conclusion: While PD-FSE offers excellent contrast, it may miss early degenerative changes. Adding MEDIC improves detection of joint effusions and bone marrow abnormalities, enhancing early diagnosis and clinical decision-making for TMDs.