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Diagnostic imaging of the temporomandibular joint has undergone a revolutionary development
during the last two decades. With advanced modalities we have been able to differentiate
between different articular entities in patients with temporomandibular joint disorders.
The purpose of this article is to review and discuss these modalities and their contribution
to our present knowledge, with emphasis made on current trends in diagnostic temporomandibular
joint imaging. The main section deals with diagnostic imaging of the subgroup of disorders
with internal derangement caused by disk displacement including posttreatment imaging.
Imaging of pathologic entities characterized by chronic inflammation such as rheumatoid
arthritis are discussed in the second section. Finally, the potential of diagnostic
imaging of infrequent conditions such as tumors is briefly reviewed. Magnetic resonance
imaging has surpassed arthrography and computed tomography for the evaluation of most
patients in these three subgroups. In patients who have various forms of disk displacements
with or without accompanying bone abnormalities, a diagnostic accuracy of at least
90% may be achieved by oblique sagittal and coronal magnetic resonance imaging. In
addition, alterations in the condylar marrow may be detected. T2-weighted magnetic
resonance imaging can make a significant diagnostic contribution by demonstrating
inflammatory reactions such as joint effusion and marrow edema. In the subgroup of
patients with chronic inflammatory diseases, magnetic resonance imaging may also demonstrate
abnormalities not shown with other imaging modalities. Disk deformation, fragmentation,
and destruction may indirectly suggest the presence of synovial proliferation/pannus
formation, which in selected cases may be directly depicted with intravenous gadopentetate
dimeglumine. For more detailed evaluation of the bone condition and of soft tissue
calcifications in joints with inflammatory diseases, tumors, or other disorders, computed
tomography is the preferable imaging modality.
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Article info
Publication history
Accepted:
June 16,
1995
Received in revised form:
April 25,
1995
Received:
April 17,
1995
Identification
Copyright
© 1995 Mosby-Year Book, Inc. Published by Elsevier Inc.