Temporomandibular Joint Disorders

<p>Superior aspect may be flattened, rounded, or markedly convex</p> Signup and view all the answers

<p>Understanding their uses, limitations, advantages, and disadvantages</p> Signup and view all the answers

<p>It helps supplement clinical examination</p> Signup and view all the answers

<p>Remodeling and arthritic conditions, trauma and fracture, tumors affecting the TMJ</p> Signup and view all the answers

<p>To aid in selecting appropriate imaging techniques</p> Signup and view all the answers

<p>MRI</p> Signup and view all the answers

<p>Fibrous adhesions and joint effusion</p> Signup and view all the answers

<p>Degenerative joint disease</p> Signup and view all the answers

<p>Degenerative joint disease</p> Signup and view all the answers

<p>Narrow or absent joint space and subchondral sclerosis</p> Signup and view all the answers

<p>Inflammatory arthritides</p> Signup and view all the answers

<p>Benign tumors</p> Signup and view all the answers

<p>Synovial membrane inflammation and osteopenia</p> Signup and view all the answers

<p>Chronic, intermittent synovial inflammation and 'bird face' facial appearance</p> Signup and view all the answers

<p>Joint destruction, redness, swelling, severe pain, and fever</p> Signup and view all the answers

<p>Widened joint space and radiopaque loose bodies</p> Signup and view all the answers

<p>Presence of calcium pyrophosphate dihydrate crystals in joints</p> Signup and view all the answers

<p>Trauma</p> Signup and view all the answers

<p>Abnormal condyle positioning</p> Signup and view all the answers

<p>Condylar neck</p> Signup and view all the answers

<p>Orthodontic and orthognathic surgery</p> Signup and view all the answers

<p>Limited jaw movement</p> Signup and view all the answers

<p>Bone destruction with ill-defined, irregular margins</p> Signup and view all the answers

<p>CT and MRI</p> Signup and view all the answers

<p>Entire ramus and condyle</p> Signup and view all the answers

<p>Surgical excision, radiotherapy, and chemotherapy</p> Signup and view all the answers

<p>Bone destruction with ill-defined, irregular margins</p> Signup and view all the answers

<p>Condyle displacement and mandibular hypoplasia</p> Signup and view all the answers

<p>MRI</p> Signup and view all the answers

<p>Enlarged condylar head and mandibular fossa with a characteristic depression of the inferior mandibular border</p> Signup and view all the answers

<p>Bilateral elongation of the coronoid process</p> Signup and view all the answers

<p>The location of the articular disc in relation to the condylar head</p> Signup and view all the answers

<p>Characteristic 'toadstool' appearance of the condylar head</p> Signup and view all the answers

<p>Trauma, infection, hereditary</p> Signup and view all the answers

<p>Small condyle with normal morphology in condylar hypoplasia</p> Signup and view all the answers

<p>Depression on the superior condylar surface giving a heart shape</p> Signup and view all the answers

<p>Inability to open the mouth</p> Signup and view all the answers

<p>More common in females</p> Signup and view all the answers

<p>The disk remains anteriorly displaced and will undergo permanent deformation</p> Signup and view all the answers

<p>The objective of the lecture is to supplement clinical examination by providing thorough knowledge about the radiographic anatomy and morphology of the temporomandibular joint, and to analyze the various hard tissue and soft tissue imaging modalities of the TMJ.</p> Signup and view all the answers

<p>The normal anatomy of the temporomandibular joint includes the mandibular condyle (head), glenoid fossa, articular tubercle (eminence), articular disc, posterior band of articular disc, anterior band of articular disc, lateral pterygoid muscle raphe, lower head of lateral pterygoid muscle, and posterior disc attachment.</p> Signup and view all the answers

<p>The shape of the condyle varies considerably, with the superior aspect maybe flattened, rounded, or markedly convex. The mediolateral contour is usually slightly convex, and variations in shape may cause difficulty with radiographic interpretation. The extreme aspects of the condyle are the medial pole and lateral pole.</p> Signup and view all the answers

<p>The characteristic radiographic feature of bifid condyle is the presence of a cleft or division in the condyle, resulting in a bifid appearance.</p> Signup and view all the answers

<p>The radiographic abnormalities of the TMJ include variations in condyle shape, abnormal disc position, degenerative joint disease, tumors affecting the TMJ (benign and malignant), trauma and fractures of the TMJ, and remodeling and arthritic conditions.</p> Signup and view all the answers

<p>The purpose of knowing the various radiographic abnormalities is to help in the selection of appropriate imaging techniques, understand their uses, limitations, advantages, and disadvantages, and to aid in the analysis of hard tissue and soft tissue imaging modalities of the TMJ.</p> Signup and view all the answers

<p>Condylar hyperplasia is characterized by excessive growth of the condyle, leading to an increase in size, while condylar hypoplasia is characterized by underdevelopment or incomplete growth of the condyle, leading to a decrease in size.</p> Signup and view all the answers

<p>Reduction disc displacement involves the ability of the displaced disc to return to its normal position upon mouth closure, while non-reduction disc displacement refers to the inability of the displaced disc to return to its normal position upon mouth closure.</p> Signup and view all the answers

<p>MRI</p> Signup and view all the answers

<p>Narrow or absent joint space and subchondral sclerosis</p> Signup and view all the answers

<p>Inflammatory arthritides</p> Signup and view all the answers

<p>Chronic, intermittent synovial inflammation and 'bird face' facial appearance</p> Signup and view all the answers

<p>Joint destruction, redness, swelling, severe pain, and fever</p> Signup and view all the answers

<p>Metaplastic formation of multiple cartilaginous and osteocartilaginous nodules within the synovial membrane</p> Signup and view all the answers

<p>Synovial membrane inflammation and osteopenia of the condyle and temporal component</p> Signup and view all the answers

<p>Narrow or absent joint space and subchondral sclerosis</p> Signup and view all the answers

<p>Benign tumors</p> Signup and view all the answers

<p>Redness, swelling, severe pain, and fever</p> Signup and view all the answers

<p>Widened joint space and radiopaque loose bodies surrounding the condylar head</p> Signup and view all the answers

<p>Narrow or absent joint space and subchondral sclerosis</p> Signup and view all the answers

<p>Chondrocalcinosis is characterized by calcium pyrophosphate dihydrate crystals in joints, more common in males, and affects the knee, wrist, shoulder, and elbow.</p> Signup and view all the answers

<p>Effusion in the temporomandibular joint results from trauma, causing joint swelling and pain, and is associated with widened joint space.</p> Signup and view all the answers

<p>Dislocation in the temporomandibular joint leads to abnormal condyle positioning and may require manual manipulation or surgery.</p> Signup and view all the answers

<p>Fractures are common at the condylar neck, causing swelling, limited range of motion, and requiring surgical reduction.</p> Signup and view all the answers

<p>Neonatal fractures from forceps delivery may result in condyle displacement and mandibular hypoplasia, and are treated with orthodontic and orthognathic surgery.</p> Signup and view all the answers

<p>Ankylosis limits jaw movement, with joint space narrowed or obliterated, and is diagnosed through coronal CT images.</p> Signup and view all the answers

<p>Tumors in the temporomandibular joint may be benign (osteoma, osteochondroma) or malignant (chondrosarcoma, osteogenic sarcoma), causing swelling, pain, and limited range of motion.</p> Signup and view all the answers

<p>Radiographic features for malignant tumors include bone destruction with ill-defined, irregular margins, and CT and MRI are useful for diagnosis.</p> Signup and view all the answers

<p>Treatment for tumors may involve surgical excision, radiotherapy, and chemotherapy.</p> Signup and view all the answers

<p>Benign tumors and cysts may involve the entire ramus and condyle, while malignant tumors can be primary (intrinsic or extrinsic) or metastatic.</p> Signup and view all the answers

<p>Neonatal fractures from forceps delivery may result in condyle displacement and mandibular hypoplasia, and are treated with orthodontic and orthognathic surgery.</p> Signup and view all the answers

<p>Oral radiology, Principles and interpretation, White and Pharoah.</p> Signup and view all the answers

<p>The radiographic features of condylar hyperplasia include enlargement and deformity of the condylar head, secondary effect on the mandibular fossa as it remodels to accommodate the abnormal condyle, characteristic depression of the inferior mandibular border, and may involve the condylar neck, glenoid fossa, ramus, and mandibular body on the affected side.</p> Signup and view all the answers

<p>The radiographic features of condylar hypoplasia include a small condyle with normal morphology, slender and shortened or elongated condylar neck and coronoid process, small ramus and mandibular body on the affected side, resulting in mandibular asymmetry and occasional dental crowding.</p> Signup and view all the answers

<p>The radiographic features of juvenile arthrosis include a characteristic 'toadstool' appearance of the condylar head, shortened or absent condylar neck, and it may be a form of condylar hypoplasia.</p> Signup and view all the answers

<p>The radiographic features of coronoid hyperplasia are best seen in panoramic, Waters, and lateral tomographic views and on CT scans. TMJs usually appear normal. Unilateral cases should be differentiated from a tumor of the coronoid process (osteochondroma or osteoma). Unlike coronoid hyperplasia, tumors have an irregular shape.</p> Signup and view all the answers

<p>The radiographic features of bifid condyle include a vertical depression, notch, or deep cleft in the center of the condylar head, resulting in a heart-shaped depression on the superior condylar surface.</p> Signup and view all the answers

<p>The radiographic features of internal derangements in the temporomandibular joint can be diagnosed by MRI. Clinical features include abnormality in the articular disc, which may interfere with normal function. MRI is the technique of choice for diagnosing internal derangements. Displacements may be unilateral or bilateral.</p> Signup and view all the answers

<p>Reduction is when an anteriorly displaced disk may reduce to a normal relationship with the condylar head during any part of the mouth opening movement. Non-reduction is when the disk remains anteriorly displaced and will undergo permanent deformation.</p> Signup and view all the answers

<p>Coronoid hyperplasia may present as acquired or developmental, with elongation of the coronoid process. It may lead to bilateral inability to open the mouth and is generally painless.</p> Signup and view all the answers

<p>Bifid condyle may present as a rare, often unilateral vertical depression, notch, or deep cleft in the center of the condylar head. Some patients may have signs of temporomandibular disorders (TMDs) such as noises and pain. Treatment is not indicated unless pain or functional impairment is present.</p> Signup and view all the answers

<p>Internal derangements in the temporomandibular joint may lead to abnormality in the articular disc and interfere with normal function. Clinical features include a decreased range of mandibular motion in symptomatic patients.</p> Signup and view all the answers

<p>Condylar hyperplasia may be caused by trauma, infection, or hereditary factors. It is more common in males and is self-limiting.</p> Signup and view all the answers

<p>Chondrocalcinosis = Calcium pyrophosphate dihydrate crystals Effusion = Widened joint space Ankylosis = Narrowed or obliterated joint space Fractures = Swelling and limited range of motion</p> Signup and view all the answers

<p>Dislocation = Manual manipulation or surgery Neonatal fractures from forceps delivery = Orthodontic and orthognathic surgery Tumors = Surgical excision, radiotherapy, and chemotherapy Ankylosis = Diagnosed through coronal CT images</p> Signup and view all the answers

<p>Benign tumors = Osteoma and osteochondroma Malignant tumors = Chondrosarcoma and osteogenic sarcoma</p> Signup and view all the answers

<p>Coronal CT images = Diagnosing ankylosis CT and MRI = Diagnosing malignant tumors Radiographic imaging = Detecting internal derangements MRI = Detecting fibrous adhesions and joint effusion</p> Signup and view all the answers

<p>Narrow or absent joint space and subchondral sclerosis = Degenerative joint disease (osteoarthritis) Erosive appearance = Inflammatory arthritides Widened joint space and radiopaque loose bodies surrounding the condylar head = Synovial chondromatosis Redness, swelling, severe pain, and fever = Septic arthritis</p> Signup and view all the answers

<p>Non-inflammatory disorder with female predominance = Degenerative joint disease (osteoarthritis) Involves synovial membrane inflammation and osteopenia of the condyle and temporal component = Rheumatoid arthritis Metaplastic formation of multiple cartilaginous and osteocartilaginous nodules within the synovial membrane = Synovial chondromatosis Chronic, intermittent synovial inflammation and &quot;bird face&quot; facial appearance = Juvenile arthritis</p> Signup and view all the answers

<p>Perforations in the retrodiscal tissue, not reliably detected with MRI = Common in TMJ, not reliably detected with MRI Fibrous adhesions and joint effusion = Detectable by MRI, particularly after TMJ surgery Radiographic features mimicking severe degenerative joint disease or rheumatoid arthritis = Radiographic features of septic arthritis Synovial membrane inflammation and osteopenia of the condyle and temporal component = Rheumatoid arthritis</p> Signup and view all the answers

<p>Posterior band of articular disc = Mandibular condyle (head) Lateral pterygoid muscle raphe = Lower head of lateral pterygoid muscle Glenoid fossa = Articular tubercle (eminence) Mandibular condyle (head) = Articular disc</p> Signup and view all the answers

<p>Remodeling and arthritic conditions = Trauma and fracture of the TMJ Trauma to the developing condyle = Tumors affecting the TMJ (benign and malignant) Soft tissue abnormalities of TMJ = Posterior disc attachment Extreme aspects of the condyle (medial and lateral pole) = Variations in shape of condyle</p> Signup and view all the answers

<p>Superior aspect of condyle = Mediolateral contour Extreme aspects of the condyle (medial and lateral pole) = Shape variations of condyle Mandibular fossa = Composed of glenoid fossa and articular eminence Condyle = Shape variations causing difficulty with interpretation</p> Signup and view all the answers

<p>Extreme aspects of the condyle (medial and lateral pole) = Variations in shape of condyle Mandibular condyle (head) = Articular disc Posterior band of articular disc = Mandibular condyle (head) Lateral pterygoid muscle raphe = Lower head of lateral pterygoid muscle</p> Signup and view all the answers

<p>Mandibular condyle (head) = Glenoid fossa Condyle = Mediolateral contour Posterior disc attachment = Soft tissue abnormalities of TMJ Articular disc = Mandibular condyle (head)</p> Signup and view all the answers

<p>Trauma to the developing condyle = Benign and malignant tumors affecting TMJ Soft tissue abnormalities of TMJ = Tumors affecting the TMJ (benign and malignant) Remodeling and arthritic conditions = Trauma and fracture of the TMJ Posterior disc attachment = Variations in shape of condyle</p> Signup and view all the answers

<p>Mandibular condyle (head) = Articular disc Extreme aspects of the condyle (medial and lateral pole) = Variations in shape of condyle Posterior band of articular disc = Mandibular condyle (head) Lateral pterygoid muscle raphe = Lower head of lateral pterygoid muscle</p> Signup and view all the answers

<p>Mandibular condyle (head) = Glenoid fossa Condyle = Mediolateral contour Posterior disc attachment = Soft tissue abnormalities of TMJ Articular disc = Mandibular condyle (head)</p> Signup and view all the answers

<p>Panoramic imaging = Best seen in panoramic, Waters, and lateral tomographic views and on CT scans CT scan = Best seen in panoramic, Waters, and lateral tomographic views and on CT scans Waters view = Best seen in panoramic, Waters, and lateral tomographic views and on CT scans MRI = Best seen in panoramic, Waters, and lateral tomographic views and on CT scans</p> Signup and view all the answers

<p>Condylar Hyperplasia = Enlargement and deformity of the condylar head Condylar Hypoplasia = The condyle is small, but condylar morphology is normal Juvenile Arthrosis = Condylar head develops a characteristic “toadstool” appearance Coronoid Hyperplasia = Elongation of the coronoid process</p> Signup and view all the answers

<p>Condylar Hyperplasia = Trauma, infection, hereditary Condylar Hypoplasia = Unknown Juvenile Arthrosis = Unknown Coronoid Hyperplasia = Acquired or developmental</p> Signup and view all the answers

<p>Panoramic imaging = Depression on the superior condylar surface giving a heart shape CT scan = Depression on the superior condylar surface giving a heart shape Waters view = Depression on the superior condylar surface giving a heart shape MRI = Depression on the superior condylar surface giving a heart shape</p> Signup and view all the answers

<p>Internal Derangements = Abnormality in the articular disc and may interfere with normal function Complete anterior disc displacement medial section = Anterior displacement of the articular disc Medial disc displacement coronal MRI = Anterior displacement of the articular disc Oblique coronal MRI = Anterior displacement of the articular disc</p> Signup and view all the answers

<p>Condylar Hyperplasia = Mandibular asymmetry Condylar Hypoplasia = Mandible deviates to the same side Juvenile Arthrosis = May be a form of condylar hypoplasia Coronoid Hyperplasia = Inability to open mouth</p> Signup and view all the answers

<p>Panoramic imaging = The condylar neck and coronoid process usually are very slender and are shortened or elongated in some cases CT scan = The condylar neck and coronoid process usually are very slender and are shortened or elongated in some cases Waters view = The condylar neck and coronoid process usually are very slender and are shortened or elongated in some cases MRI = The condylar neck and coronoid process usually are very slender and are shortened or elongated in some cases</p> Signup and view all the answers

<p>Panoramic imaging = Condylar head develops a characteristic “toadstool” appearance CT scan = Condylar head develops a characteristic “toadstool” appearance Waters view = Condylar head develops a characteristic “toadstool” appearance MRI = Condylar head develops a characteristic “toadstool” appearance</p> Signup and view all the answers

<p>Panoramic imaging = Internal derangements can be diagnosed by MRI CT scan = Internal derangements can be diagnosed by MRI Waters view = Internal derangements can be diagnosed by MRI MRI = Internal derangements can be diagnosed by MRI</p> Signup and view all the answers

<p>Panoramic imaging = Condylar neck, glenoid fossa, ramus and mandibular body on the affected side may also be enlarged, resulting in a characteristic depression of the inferior mandibular border CT scan = Condylar neck, glenoid fossa, ramus and mandibular body on the affected side may also be enlarged, resulting in a characteristic depression of the inferior mandibular border Waters view = Condylar neck, glenoid fossa, ramus and mandibular body on the affected side may also be enlarged, resulting in a characteristic depression of the inferior mandibular border MRI = Condylar neck, glenoid fossa, ramus and mandibular body on the affected side may also be enlarged, resulting in a characteristic depression of the inferior mandibular border</p> Signup and view all the answers

<p>Panoramic imaging = Depression on the superior condylar surface giving a heart shape CT scan = Depression on the superior condylar surface giving a heart shape Waters view = Depression on the superior condylar surface giving a heart shape MRI = Depression on the superior condylar surface giving a heart shape</p> Signup and view all the answers

<p>Autopsy = MRI is the technique of choice Open-mouth MRI = MRI is the technique of choice Medial disc displacement coronal MRI = MRI is the technique of choice Oblique coronal MRI = MRI is the technique of choice</p> Signup and view all the answers