Role of Radiology in Diagnosis of Temporomandibular Joint Disorders

Abstract

The diagnosis and management of temporomandibular disorders (TMD) require both clinical andimaging examinations of the temporomandibular joint (TMJ). A variety of modalities can be used toimage the TMJ, including magnetic resonance imaging (MRI), computed tomography (CT), cone beamCT, ultrasonography, conventional radiography. The present review outlines the indications of the mostfrequently used imaging techniques in TMD diagnosis.Because of the anatomic complexity of the TMJ, imaging can be difficult. Choosing the properimaging technique is essential. Conventional radiography, nowadays, is of limited interest. The useof flat plane films for TMJ pathology is not sufficient, because this joint requires three dimensionalimaging views. Osseous changes are better visualized with CT and cone beam CT. Cone beam CTprovides high-resolution multiplanar reconstruction of the TMJ, with a low radiation dose, withoutsuperimposition of the bony structures. MRI is a noninvasive technique, considered to be the goldstandard in imaging the soft tissue components of the TMJ. MRI is used to evaluate the articular disc interms of location and morphology. Moreover, the early signs of TMD and the presence of joint effusioncan be determined. High-resolution ultrasonography is a noninvasive, dynamic, inexpensive imagingtechnique, which can be useful in diagnosing TMJ disc displacements. The diagnostic value of highresolutionultrasonography is strictly dependent on the examiner’s skills and on the equipment used.