[Morphological and positional changes in the disk after nonsurgical therapy. The MRI documentation and clinical correlations]. / I mutamenti morfologici e posizionali del disco dopo terapia non chirurgica. Documentazione in RMN e correlazioni cliniche.

ABSTRACT

AIMS: To evaluate the position and shape of the disc using MNR before and after non-surgical therapy and to correlate MNR findings with other signs and symptoms. METHODS: MNR imaging of 26 joints belonging to a selected sample of 13 patients (7 F, 6 M, mean age 27 years) with signs and symptoms were compared with MNR performed after a period of non-surgical treatment that included a combination of splint therapy, psychoeducational advice, drugs and physiotherapeutic aids, including manipulation. The criteria for selection were monolateral symptoms and bilateral nature at the initial NMR showing reducible and non-reducible dislocation not associated with degenerative changes and/or effusion. The interval between diagnostic NMR and control imaging was approximately 12 months. The interval between splint application and control NMR was approximately 8 months. NMR included a sagittal study with the mouth open and shut and a coronal study only with the mouth shut using 3 mm-wide cuts. Post-therapy RMN was performed without the splint in position. RESULTS: The comparison between NMR images showed that 17 of the 26 joints studied had a stationary pathological situation and 9 were in evolution. In spite of these pathological NMR images, the signs and symptoms were found to have regressed or improved. CONCLUSIONS: These findings can be interpreted in two ways the disc dislocation and deformation are compatible with the lack of signs and symptoms, or many dislocations should be regarded as an anatomical variation rather than an abnormality.