Ultrasound assessment of temporomandibular disorders: comparative analysis between inflammatory and degenerative patterns in rheumatic and non-rheumatic patients

Ultrasound is a sensitive, non-invasive tool for assessing TMJ involvement, particularly in distinguishing inflammatory from mechanical patterns. Its integration into clinical evaluation improves diagnostic accuracy and informs more personalized management. Key Points • Ultrasound (US) effectively distinguishes inflammatory from mechanical temporomandibular joint (TMJ) involvement, particularly in patients with autoimmune inflammatory rheumatic diseases (AIIRDs), outperforming clinical examination alone. • Inflammatory US features (e.g., joint effusion, synovial hypertrophy, power Doppler signal) were significantly more common in AIIRD patients, while degenerative features were present across all groups, including fibromyalgia and non-rheumatologic TMD. • Erosions were the only US finding significantly associated with TMJ symptoms, underscoring their potential clinical relevance in patient evaluation and management. • Integration of TMJ US into routine assessment improves diagnostic accuracy, supporting more personalized treatment strategies by identifying inflammatory versus mechanical patterns of TMJ involvement.