Associations Between MRI Findings and Pain, Joint Sounds, and Limited Mouth Opening in Patients with Temporomandibular Disorders

Background/Objectives: Associations between temporomandibular joint (TMJ) magnetic resonance imaging (MRI) findings and clinical manifestations vary across studies. This study aimed to examine associations of disc position and MRI findings with joint pain and sounds and to explore their relationships with limited mouth opening. Methods: This retrospective cross-sectional study included 108 patients and 216 TMJs. MRI assessment included disc position, disc morphology, condylar changes, and effusion volume. Analyses of pain, clicking, and crepitus accounted for within-patient correlation between bilateral joints. Maximum assisted mouth opening was measured, and limited mouth opening was analyzed separately for each patient. Results: Anterior disc displacement with reduction (ADDwR) and anterior disc displacement without reduction (ADDwoR) showed nominal associations with joint pain (adjusted odds ratio [OR] 3.60, 95% confidence interval [CI] 1.89–6.86; OR 2.90, 95% CI 1.14–7.36, respectively) and clicking (OR 5.70, 95% CI 2.56–12.70; OR 3.71, 95% CI 1.15–11.93, respectively), compared with normal disc position. Condylar erosion was not associated with pain (OR 2.62, 95% CI 0.92–7.50). ADDwoR and condylar erosion in at least one joint were associated with limited mouth opening (OR 3.61, 95% CI 1.43–9.11; OR 2.98, 95% CI 1.19–7.45, respectively). After adjustment for multiple comparisons, the associations of ADDwR with pain and clicking remained statistically significant (both q = 0.004), whereas those of ADDwoR did not reach statistical significance (both q = 0.053). Conclusions: ADDwR was associated with joint pain and clicking, whereas ADDwoR and condylar erosion in at least one joint were associated with limited mouth opening. However, these findings should be interpreted in light of the retrospective design, the absence of asymptomatic controls, and nominal significance thresholds.