Correlation Between MRI Findings and Clinical Improvement Following TMJ Injection With Hyaluronic Acid and Platelet-Rich Plasma

Temporomandibular joint (TMJ) disorders can cause jaw pain, clicking sounds, and difficulty opening the mouth, affecting daily activities such as eating and speaking. This study aims to determine whether magnetic resonance imaging (MRI) findings can help predict how much patients improve after a single injection into the TMJ containing hyaluronic acid and platelet-rich plasma (PRP). Adults with TMJ internal derangement who have not improved with conservative treatment will receive one injection of hyaluronic acid combined with PRP prepared from their own blood. Participants will be evaluated before treatment and at follow-up visits over 6 months. Assessments will include pain, jaw function, mouth opening, and MRI scans before and after treatment. The results of this study may improve understanding of the relationship between MRI findings and treatment outcomes and help healthcare providers identify patients who are most likely to benefit from this minimally invasive therapy.

Inclusion Criteria: * 1\. Patients age between (18 -45). 2. Early/intermediate stage according to (Wilkes classification). 3. Patients have painful joint, clicking sound, with or without limited mouth opening. 4\. Patients unresponsive to conservative treatment. 5. Patient's ability and desire to complete the treatment protocol and follow up visits. 6\. Patients with internal derangement with reduction confirmed by MRI imaging Exclusion Criteria: \- 1. Patient with an inflammatory or connective tissue disease 2. Patient with previous invasive TMJ surgical procedure. 3. neurologic disorders 4. History of injection of any substance into the target TMJ during previous 6 months. 5\. Patient with history of bony or fibrous adhesion. 6. Internal derangement without reduction. 7. Patient with psychological problem