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Skeletal Radiol 2020 Mar 11. Epub 2020 Mar 11.

Division of Neuroradiology, Brigham & Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, 02135, USA.

Temporomandibular disorders encompass multiple pathologies of the temporomandibular joint that manifest as middle/inner ear symptoms, headache, and/or localized TMJ symptoms. There is an important although somewhat limited role of imaging in the diagnostic evaluation of temporomandibular disorders. In this manuscript, we provide a comprehensive review of TMJ anatomy, outline potentially important features of TMJ disc ultrastructure and biochemistry in comparison with the intervertebral disc and knee meniscus, and provide imaging examples of the TMJ abnormalities currently evaluable with MRI and CT. Read More

Folia Morphol (Warsz) 2009 May;68(2):59-64

Experimental Teratology Unit of the Human Anatomy Department, Medical University of Lublin, Poland.

Joint formation is a developmental process regulated by various factors including bone morphogenetic proteins, transforming and growth factors, etc. Recently, a high expression of cyclooxygenase (COX) isoforms in the foetal cartilaginous elements was also revealed. On the other hand, various joint and skeletal abnormalities were seen in laboratory animal and human offspring, exposed in utero to several COX inhibitors. Read More

Br J Oral Maxillofac Surg 2002 Jun;40(3):220-8

Royal United Hospital, Weston, Bath, UK.

In this pictorial essay we aim to illustrate the normal temporomandibular joint (TMJ) and the common abnormalities of the osseous, cartilaginous and soft tissue components. These include disc (meniscus) displacement, deformities and perforations, abnormalities of disc and condylar movement, joint effusions, synovial proliferation, condylar deformity and erosions, degenerative change and abnormal retrodiscal enhancement. Read More

Nihon Igaku Hoshasen Gakkai Zasshi 1991 Aug;51(8):912-22

Center for Radiological Science, Iwate Medical University.

Arthrosis of the temporomandibular joint (TMJ) is a noninfectious, noninflammatory condition characterized by joint pain, noise (clicking) and abnormal motion. It contains various disease processes, such as abnormalities in the menisci or masticating muscles, subluxation of the condyle and degenerative joint disease. Analysis of the morphology and dynamics of TMJ by means of imaging modalities has become highly advanced since the development of arthrography in the late 1970s. Read More

Br J Oral Maxillofac Surg 1989 Apr;27(2):156-62

King Khalid National Guard Hospital, Jeddah, Kingdom of Saudi Arabia.

A retrospective study of 106 patients who underwent temporomandibular joint surgery for meniscal dysfunction was conducted. The patients were evaluated by tomography and arthrography of the temporomandibular joint and abnormalities of the hard and soft tissue structures were determined by these investigations and compared directly with the findings at surgical examination. Tomography had a high degree of correlation with bony pathology as did arthrography with meniscal displacement. Read More

J Craniomandib Disord 1989 ;3(3):174-8

Advancement of surgical techniques has made it necessary to accurately diagnose internal derangements. Arthrography and computerized tomography have been used to diagnose the majority of temporomandibular joint disorders; however, these methods have had their disadvantages. Magnetic resonance imaging utilizing surface coils has greatly improved the ability to diagnose meniscus abnormalities without using interarticular injections or ionizing radiation. Read More

Oral Surg Oral Med Oral Pathol 1987 Jul;64(1):6-8

Two hundred five patients were prospectively examined for temporomandibular joint pain. Arthrograms were performed on 222 joints (188 unilateral and 17 bilateral). Pain in the ear occurred more frequently in arthrographically normal patients and in nonreducing meniscus patients compared with reducing meniscus patients. Read More

Rofo 1986 Jul;145(1):38-43

79 patients aged 6 to 66 years (9 men and 70 women) with abnormalities of the TMJs were examined by magnetic resonance tomography (132 joints) and the results were compared with CT (16 joints) and arthrography (39 joints). Magnetic resonance tomography showed forward luxation of the meniscus in 82 joints (62%). In 34 joints (26%) the meniscus spontaneously resumed normal position when the mouth was open, but in 48 joints (36%) the displacement was permanent. Read More

J Comput Tomogr 1985 Oct;9(4):351-8

Computed tomography of the temporomandibular joint has been shown to be an accurate method of assessing the position of the disk. To date, we have examined over 500 patients with this modality and have found it also to be effective in the evaluation of other osseous and soft tissue abnormalities. An overview of temporomandibular joint pathology is presented, including the range of osteoarthritic changes from spur formation to complete fusion. Read More

Radiology 1985 Oct;157(1):133-6

A total of 115 temporomandibular joints (TMJ) in 67 patients were examined by high resolution magnetic resonance (MR) using a surface coil. Five millimeter sections were imaged using a two-dimensional multisection acquisition. Findings of MR examinations were correlated with findings of conventional radiographic and clinical examinations. Read More

Mondo Ortod 1985 Sep-Oct;10(5):15-22

Oral Surg Oral Med Oral Pathol 1985 Sep;60(3):244-51

The range of mandibular movements has been correlated with arthrographic findings of the temporomandibular joint in 205 patients. Abnormalities of meniscus position and function have been found to influence mandibular movements in characteristic patterns. However, altered mandibular movements alone are insufficient for a definitive clinical diagnosis of the specific type of internal derangement of the temporomandibular joint. Read More

Rofo 1984 Feb;140(2):187-90

Most abnormalities in the T.M. joint are due to pathological processes in the meniscus or joint capsule. Read More

Radiology 1984 Jan;150(1):250-4

Accessory patient support equipment was constructed that allows patient positioning for true sagittal projection of the temporomandibular joint using a GE 8800 CT/T scanner. Range of motion abnormalities, osseous alterations of the mandibular condyle and temporal bone, joint-space narrowing, and meniscal configuration may be demonstrated. The technique has potential advantages over other CT projections and sagittal reconstruction for evaluation of temporomandibular joint dysfunction. Read More

J Prosthet Dent 1983 May;49(5):711-4

Diagnosis of TMJ complaints is a complex and difficult task. To better define treatment procedures a firm diagnosis must be established. Radiographs are an aid in confirming diagnosis of TMJ abnormalities. Read More

J Prosthet Dent 1983 Feb;49(2):250-4

Subjects experiencing painful dysfunction of the TMJ and diagnosed by arthrography to have displacements of the meniscus were compared to normal or asymptomatic subjects to assess condyle-fossa relationships. The groups did not differ by linear or area determinations of the P/A ratio. The use of plain film alone is not adequate for diagnosis or assessment of treatment if abnormalities of meniscus function are the primary etiology. Read More

Arch Otolaryngol 1981 Jun;107(6):337-9

Temporomandibular joint (TMJ) dysfunction may cause facial or aural pain. Conventional roentgenograms are useful to define bony pathologic conditions. However, TMJ arthrotomography may disclose joint meniscus abnormalities in two thirds of patients with persistent dysfunction despite normal roentgenograms. Read More

Oral Surg Oral Med Oral Pathol 1981 Jun;51(6):569-74

A simplified arthrotomographic technique has been performed successfully in more than 200 patients with symptoms referable to the temporomandibular joint. Soft-tissue abnormalities not detected by plain film radiography were demonstrated. Anterior meniscus displacement was the most significant finding in patients with unilateral pain and limitation of opening. Read More

AJR Am J Roentgenol 1980 May;134(5):995-1003

A series of 104 arthrotomographic examinations of the temporomandibular joint in 89 patients is described. Those patients with symptoms referable to the temporomandibular joint and not responsive to conservative methods of therapy were selected. The mean patient age was 29 years with a 3:1 female to male ratio. Read More

J Oral Surg 1979 Nov;37(11):793-9

Thirty-five arthrotomograms of the temporomandibular joint (TMJ) were done on 33 patients who had chronic pain and dysfunction of the TMJ. All patients were refractory to conservative treatment. Five arthrotomograms were normal; abnormalities were observed in 30. Read More

AJR Am J Roentgenol 1979 Jun;132(6):949-55

A technique for arthrography of the temporomandibular joint using multidirectional tomography is described that greatly simplifies interpretation. In 21 attempts, 20 successful arthrograms were obtained in patients complaining of pain, tenderness, and clicking and locking of the joint who had not responded to conservative therapy. Abnormalities demonstrated were perforation of the meniscus, anterior dislocation and subluxation of the meniscus; and redundancy of the bilaminar zone. Read More