April 6, 2010

Temporomandibular Osteoarthritis

Coronal and sagittal CT images of the temporomandibular (TM) joints show narrowing of the joint spaces, rough articular surface, erosions and subchondral sclerosis. Abnormal contour of the condyles and eminences are due to severe degenerative disease.

  • Degenerative joint disease is the most common disease of the TM joint
  • On histopathological study, it is found in 40% of cases over 40 years of age
  • Changes in the articular surface originates in posterior aspect then spreads to larger areas, cartilage loss results in destruction of condyle, bony eburnation, flattening and joint space narrowing
  • Often associated with internal derangements related to meniscal dysfunction (dislocation with or without reduction)
  • On radiograph, CT and MRI, there is "roughening" of condylar surface, flattening of condyle and eminence, osteophytes, eburnation (cartilage replaced by bone at the site of erosion) and narrowing of joint spaces
  • CT arthrography or MRI are likely the optimal imaging means to evaluation status of meniscus
Katzberg RW, Keith DA, Guralnick WC, et al. Internal derangement and arthritis of the temporomandibular joint. Radiology 1983;146:107-112.

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