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Cross-sectional and Functional Imaging of the Temporomandibular Joint: Radiology, Pathology, and Basic Biomechanics of the Jaw¹

¹ From the Department of Radiology (O.J.S., M.S.) and Institute of Oral and Maxillofacial Surgery and Dentistry (W.M.), Hospital Lainz, Wolkersbergenstrasse 1, Vienna, Austria 1130; Institute of Anatomy, University Innsbruck, Austria (F.A., H.F.); and the Department of Radiology, University Hospital Innsbruck, Austria (A.R., H.G.). Presented as an educational exhibit at the 2002 RSNA scientific assembly. Received March 14, 2003, revision requested May 13, revision received and accepted July 8. Address correspondence to O.J.S. (e-mail: oliver.sommer@wienkav.at).

The temporomandibular joint (TMJ) is a common site of complaint. Clicking sounds and pain are indicators of a frequent condition called internal derangement, most often affecting females. As a general term, internal derangement describes a structural abnormality within an articulation. The internal derangement of the TMJ is a specific term defined as an abnormal positional and functional relationship between the disk and articulating surfaces. Imaging of the joint is an important element in the diagnostic work-up. Trauma and inflammatory arthritis account for most of the other TMJ problems. A thorough understanding of joint anatomy and normal function is a prerequisite for perceiving abnormalities and making the correct diagnosis. The authors elucidate joint anatomy, correlating cadaveric specimen and anatomic slices with conventional and cross-sectional imaging studies. TMJ biomechanics are illustrated with schematics and animations, and an overview of imaging strategies and techniques is presented. Common abnormalities are described and illustrated, and a brief discussion of therapeutic options is included.

© RSNA, 2003

Index Terms: Joints, abnormalities, 244.14, 244.42, 244.78 • Joints, MR, 244.12141 • Joints, temporomandibular, 244.91

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