Sex-based differences in clinical and MRI features of temporomandibular disorders: A cross-sectional study in a Brazilian sample

Objectives: To compare the frequency of clinical symptoms and magnetic resonance imaging (MRI) findings of temporomandibular disorders (TMD) between females and males. Methods: A cross-sectional study was conducted using the medical records and MRI scans of the temporomandibular joints of 56 adult patients with a history of TMD. Clinical data were obtained through chart reviews, and MRI evaluations were performed by a blinded, calibrated radiologist. The variables considered included headache, joint pain, joint clicking, and imaging features such as disc signal changes, bone alterations, effusion, disc excursion and disc displacement. Statistical analyses included bivariate comparisons and multivariate logistic regression adjusted for age. Results: Females demonstrated a significantly higher prevalence of disc signal changes and anterior disc displacement with reduction compared to males. These associations remained statistically significant even after adjusting for age. No significant differences were observed for other clinical or imaging variables. Conclusion: The present findings highlight the importance of considering sex-related differences, particularly with regard to the higher prevalence of disc signal changes and anterior disc displacement with reduction in females, when diagnosing and managing TMD. However, the retrospective design and limitations in sample size should be considered when interpreting these results. Statement of clinical relevance: Based on the study finding that females had a higher prevalence of disc signal changes and anterior disc displacement, clinicians should lower the threshold for ordering advanced imaging, such as an MRI, for female patients presenting with TMD symptoms. This information can inform more personalized and proactive management, potentially prioritizing conservative, joint-stabilizing therapies earlier in the treatment process for women to reduce the risk of disease progression.