Image diagnosis for internal derangements of the temporomandibular joint

Abstract

1. Relationship of the articular disk to the condyle. This study consisted of 175 patients (181 joints) out of 203 patients reviewed. Thirty-eight joints showed anterior disk displacement with reduction, 76 joints showed anterior disk displacement without reduction and 40 joints showed anterior disk displacement with associated perforation of the posterior attachment of the disk. 2. Capsular adhesions of internal derangements of the TMJ. Fifty-five joints (70%) had capsular adhesion in joints showing anterior disk displacement without reduction. Nine joints (21%) had capsular adhesion in joints showing anterior disk displacement with reduction. Arthrotomographically 9 patients were found to have only capsular adhesion without displacement of the disk. 3. Osseous abnormalities of internal derangements of the TMJ. One hundred and one joints were studied. In the patients with anterior disk displacement without reduction, thirty-seven (67%) out of 55 joints had erosive bone changes on the condyle. Nine (17%) out of fifty-three joints with asymptomatic and clinically normal TMJ had erosive bone changes on the condyle. 4. Comparison of double-contrast arthrotomography and MR imaging at 0.2 T. Both methods of evaluation provided highly reliable information regarding the disk. Double-contrast arthrotomography was superior to MR imaging in detecting capsular adhesion and perforation of the posterior attachment. 5. Selection of routine radiographic techniques of the TMJ. The lateral tomograph produced the highest diagnostic accuracy (90%). The diagnostic accuracy of osseous changes of the TMJ is better with rotational panoramic radiography than with lateral oblique transcranial radiography.