Semin Musculoskelet Radiol 2020; 24(05): 591-607
DOI: 10.1055/s-0040-1701631
Review Article

Temporomandibular Joint Disorders: A Pictorial Review

1   Department of Radiology, AZ Sint-Jan Brugge, Bruges, Belgium
2   Department of Radiology, Ghent University Hospital, Ghent, Belgium
,
Jan W. Casselman
1   Department of Radiology, AZ Sint-Jan Brugge, Bruges, Belgium
2   Department of Radiology, Ghent University Hospital, Ghent, Belgium
3   Department of Radiology, GZA Sint-Augustinus Antwerp, Antwerp, Belgium
› Author Affiliations

Abstract

Temporomandibular joint (TMJ) disorders are commonly encountered in the general population but often ignored or unrecognized. The detection and characterization of lesions has drastically improved over the years due to technological advances in cone beam computed tomography (CBCT) and magnetic resonance imaging (MRI). However, adequate knowledge of the normal imaging appearance on different imaging modalities as well as the broad variety of pathology is required to provide a proper radiologic assessment. This pictorial review focuses on TMJ pathology and its appearance on CBCT and MRI. A short overview of the technical aspects and normal anatomy are provided to round out this complete summary on the subject.

Supplementary Material



Publication History

Article published online:
09 October 2020

© 2020. Thieme. All rights reserved.

Thieme Medical Publishers
333 Seventh Avenue, New York, NY 10001, USA.

 
  • References

  • 1 Aiken A, Bouloux G, Hudgins P. MR imaging of the temporomandibular joint. Magn Reson Imaging Clin N Am 2012; 20 (03) 397-412
  • 2 Krishnamoorthy B, Mamatha N, Kumar VA. TMJ imaging by CBCT: current scenario. Ann Maxillofac Surg 2013; 3 (01) 80-83
  • 3 Scarfe WC, Farman AG, Sukovic P. Clinical applications of cone-beam computed tomography in dental practice. J Can Dent Assoc 2006; 72 (01) 75-80
  • 4 Bag AK, Gaddikeri S, Singhal A. et al. Imaging of the temporomandibular joint: an update. World J Radiol 2014; 6 (08) 567-582
  • 5 Milam SB. Pathogenesis of degenerative temporomandibular joint arthritides. Odontology 2005; 93 (01) 7-15
  • 6 Alomar X, Medrano J, Cabratosa J. et al. Anatomy of the temporomandibular joint. Semin Ultrasound CT MRI. 2007; 28 (03) 170-183
  • 7 Tomas X, Pomes J, Berenguer J. et al. MR imaging of temporomandibular joint dysfunction: a pictorial review. Radiographics 2006; 26 (03) 765-781
  • 8 Drace JE, Enzmann DR. Defining the normal temporomandibular joint: closed-, partially open-, and open-mouth MR imaging of asymptomatic subjects. Radiology 1990; 177 (01) 67-71
  • 9 Krogstad O. Aplasia of the mandibular condyle. Eur J Orthod 1997; 19 (05) 483-489
  • 10 Shafer WG, Hine MK, Levy BM, Rajendran R, Sivapathasundharam B. A Textbook of Oral Pathology. 4th ed. Philadelphia, PA: WB Saunders; 1983
  • 11 Kaneyama K, Segami N, Hatta T. Congenital deformities and developmental abnormalities of the mandibular condyle in the temporomandibular joint. Congenit Anom (Kyoto) 2008; 48 (03) 118-125
  • 12 Tank W, Wright D, Iizuka T. Unilateral dysplasia of the mandibular condyle: report of a case. J Oral Maxillofac Surg 1998; 56 (06) 765-769
  • 13 Angiero F, Farronato G, Benedicenti S. et al. Mandibular condylar hyperplasia: clinical, histopathological, and treatment considerations. Cranio 2009; 27 (01) 24-32
  • 14 Acharya P, Stewart A, Naini FB. Coronoid impingement syndrome: literature review and clinical management. Maxillofac Plast Reconstr Surg 2017; 39 (01) 11
  • 15 Movahed R, Mercuri LG. Management of temporomandibular joint ankylosis. Oral Maxillofac Surg Clin North Am 2015; 27 (01) 27-35
  • 16 Haug RH, Prather J, Indresano AT. An epidemiologic survey of facial fractures and concomitant injuries. J Oral Maxillofac Surg 1990; 48 (09) 926-932
  • 17 Koenig L, Tamimi D, Petrikowski G, Perschbacher S. Diagnostic Imaging: Oral and Maxillofacial. 2nd ed. Philadelphia, PA: Elsevier; 2017
  • 18 Mezitis M, Rallis G, Zachariades N. The normal range of mouth opening. J Oral Maxillofac Surg 1989; 47 (10) 1028-1029
  • 19 Lowery LE, Beeson MS, Lum KK. The wrist pivot method, a novel technique for temporomandibular joint reduction. J Emerg Med 2004; 27 (02) 167-170
  • 20 Harstall R, Gratz KW, Zwahlen RA. Mandibular condyle dislocation into the middle cranial fossa: a case report and review of literature. J Trauma 2005; 59 (06) 1495-1503
  • 21 Akinbami BO. Evaluation of the mechanism and principles of management of temporomandibular joint dislocation. Systematic review of literature and a proposed new classification of temporomandibular joint dislocation. Head Face Med 2011; 7 (01) 10
  • 22 Smolka W, Sotlar K, Weiss M, Müller-Lisse U. Osteochondrosis dissecans of the temporomandibular joint: a case report and a review of literature. Oral Maxillofac Surg 2016; 20 (03) 321-325
  • 23 Silman AJ, Pearson JE. Epidemiology and genetics of rheumatoid arthritis. Arthritis Res 2002; 4 (03) (Suppl. 03) S265-S272
  • 24 Lin Y-C, Hsu M-L, Yang J-S, Liang T-H, Chou S-L, Lin H-Y. Temporomandibular joint disorders in patients with rheumatoid arthritis. J Chin Med Assoc 2007; 70 (12) 527-534
  • 25 Mehra P, Wolford LM, Baran S, Cassano DS. Single-stage comprehensive surgical treatment of the rheumatoid arthritis temporomandibular joint patient. J Oral Maxillofac Surg 2009; 67 (09) 1859-1872
  • 26 Cordeiro PC, Guimaraes JP, de Souza VA. et al. Temporomandibular joint involvement in rheumatoid arthritis patients: association between clinical and tomographic data. Acta Odontol Latinoam 2016; 29 (03) 123-129
  • 27 Petty RE, Southwood TR, Manners P. , et al; International League of Associations for Rheumatology. International League of Associations for Rheumatology classification of juvenile idiopathic arthritis: second revision, Edmonton, 2001. J Rheumatol 2004; 31 (02) 390-392
  • 28 Hechler BL, Phero JA, Van Mater H, Matthews NS. Ultrasound versus magnetic resonance imaging of the temporomandibular joint in juvenile idiopathic arthritis: a systematic review. Int J Oral Maxillofac Surg 2018; 47 (01) 83-89
  • 29 Ringold S, Cron RQ. The temporomandibular joint in juvenile idiopathic arthritis: frequently used and frequently arthritic. Pediatr Rheumatol Online J 2009; 7 (01) 11
  • 30 Ferraz Jr AM, Devito KL, Guimarães JP. Temporomandibular disorder in patients with juvenile idiopathic arthritis: clinical evaluation and correlation with the findings of cone beam computed tomography. Oral Surg Oral Med Oral Pathol Oral Radiol 2012; 114 (03) e51-e57
  • 31 Al-Shwaikh H, Urtane I, Pirttiniemi P. et al. Radiologic features of temporomandibular joint osseous structures in children with juvenile idiopathic arthritis. Cone beam computed tomography study. Stomatologija 2016; 18 (02) 51-60
  • 32 Stoll ML, Kau CH, Waite PD, Cron RQ. Temporomandibular joint arthritis in juvenile idiopathic arthritis, now what?. Pediatr Rheumatol Online J 2018; 16 (01) 32-32
  • 33 Damodar D, Chan N, Kokot N. Pigmented villonodular synovitis of the temporomandibular joint: case report and review of the literature. Head Neck 2015; 37 (12) E194-E199
  • 34 Tanaka E, Detamore MS, Mercuri LG. Degenerative disorders of the temporomandibular joint: etiology, diagnosis, and treatment. J Dent Res 2008; 87 (04) 296-307
  • 35 Brooks SL, Westesson P-L, Eriksson L, Hansson LG, Barsotti JB. Prevalence of osseous changes in the temporomandibular joint of asymptomatic persons without internal derangement. Oral Surg Oral Med Oral Pathol 1992; 73 (01) 118-122
  • 36 Okochi K, Nakamura S, Tetsumura A, Honda E, Kurabayashi T. Magnetic resonance imaging of temporomandibular joint cyst. Oral Surg Oral Med Oral Pathol Oral Radiol 2012; 113 (06) 827-831
  • 37 Steen MW, Hofstede DJ. Ganglion and synovial cyst of the temporomandibular joint: a case report and literature review. Plast Reconstr Surg Glob Open 2015; 3 (09) e524-e524
  • 38 Hatcher DC. Progressive condylar resorption: pathologic processes and imaging considerations. Semin Orthod 2013; 19 (02) 96-105
  • 39 Gunson MJ, Arnett GW, Formby B, Falzone C, Mathur R, Alexander C. Oral contraceptive pill use and abnormal menstrual cycles in women with severe condylar resorption: a case for low serum 17β-estradiol as a major factor in progressive condylar resorption. Am J Orthod Dentofacial Orthop 2009; 136 (06) 772-779
  • 40 Eversole LR, Machado L. Temporomandibular joint internal derangements and associated neuromuscular disorders. J Am Dent Assoc 1985; 110 (01) 69-79
  • 41 Young AL. Internal derangements of the temporomandibular joint: a review of the anatomy, diagnosis, and management. J Indian Prosthodont Soc 2015; 15 (01) 2-7
  • 42 Dolwick MF. The role of temporomandibular joint surgery in the treatment of patients with internal derangement. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1997; 83 (01) 150-155
  • 43 Nojima K, Niizuma-Kosaka F, Nishii Y. et al. Multidisciplinary treatment of peripheral osteoma arising from mandibular condyle in patient presenting with facial asymmetry. Bull Tokyo Dent Coll 2014; 55 (01) 39-47
  • 44 Saito T, Utsunomiya T, Furutani M, Yamamoto H. Osteochondroma of the mandibular condyle: a case report and review of the literature. J Oral Sci 2001; 43 (04) 293-297
  • 45 Jaffe HL. Tumors and tumorous conditions of the bones and joints. Acad Med 1959; 34 (01) 72
  • 46 Bennett JH, Thomas G, Evans AW, Speight PM. Osteosarcoma of the jaws: a 30-year retrospective review. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2000; 90 (03) 323-332
  • 47 Wang S, Shi H, Yu Q. Osteosarcoma of the jaws: demographic and CT imaging features. Dentomaxillofac Radiol 2012; 41 (01) 37-42
  • 48 Gallego L, Junquera L, Fresno MF, de Vicente JC. Chondrosarcoma of the temporomandibular joint. A case report and review of the literature. Med Oral Patol Oral Cir Bucal 2009; 14 (01) E39-E43
  • 49 Lee SY, Lim YC, Song MH, Seok JY, Lee WS, Choi EC. Chondrosarcoma of the head and neck. Yonsei Med J 2005; 46 (02) 228-232
  • 50 Koch BB, Karnell LH, Hoffman HT. et al. National cancer database report on chondrosarcoma of the head and neck. Head Neck 2000; 22 (04) 408-425
  • 51 Miles BA, Schwartz-Dabney C, Sinn DP, Kessler HP. Bilateral metastatic breast adenocarcinoma within the temporomandibular joint: a case report. J Oral Maxillofac Surg 2006; 64 (04) 712-718
  • 52 Smolka W, Brekenfeld C, Büchel P, Iizuka T. Metastatic adenocarcinoma of the temporomandibular joint from the cardia of the stomach: a case report. Int J Oral Maxillofac Surg 2004; 33 (07) 713-715
  • 53 Qiu YT, Yang C, Chen MJ, Qiu WL. Metastatic spread to the mandibular condyle as initial clinical presentation: radiographic diagnosis and surgical experience. J Oral Maxillofac Surg 2013; 71 (04) 809-820
  • 54 Kruse AL, Luebbers HT, Obwegeser JA, Edelmann L, Graetz KW. Temporomandibular disorders associated with metastases to the temporomandibular joint: a review of the literature and 3 additional cases. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2010; 110 (02) e21-e28
  • 55 Shintaku WH, Venturin JS, Yepes JF. Application of advanced imaging modalities for the diagnosis of metastatic adenocarcinoma of the lungs in the temporomandibular joint. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009; 107 (06) e37-e41
  • 56 Deeming G, Divakaran R, Butterworth D, Foster M. Temporomandibular region metastasis from cystosarcoma phyllodes: a case report and review of the literature. J Craniomaxillofac Surg 2003; 31 (05) 325-328
  • 57 Holmlund AB, Eriksson L, Reinholt FP. Synovial chondromatosis of the temporomandibular joint: clinical, surgical and histological aspects. Int J Oral Maxillofac Surg 2003; 32 (02) 143-147
  • 58 Guarda-Nardini L, Piccotti F, Ferronato G, Manfredini D. Synovial chondromatosis of the temporomandibular joint: a case description with systematic literature review. Int J Oral Maxillofac Surg 2010; 39 (08) 745-755
  • 59 Pau M, Bicsák A, Reinbacher KE, Feichtinger M, Kärcher H. Surgical treatment of synovial chondromatosis of the temporomandibular joint with erosion of the skull base: a case report and review of the literature. Int J Oral Maxillofac Surg 2014; 43 (05) 600-605
  • 60 Milgram JW. Synovial osteochondromatosis: a histopathological study of thirty cases. J Bone Joint Surg Am 1977; 59 (06) 792-801
  • 61 Chen MJ, Yang C, Qiu YT, Jiang Q, Shi HM, Wei WB. Synovial chondromatosis of the temporomandibular joint: relationship between MRI information and potential aggressive behavior. J Craniomaxillofac Surg 2015; 43 (03) 349-354
  • 62 Laviv A, Sadow PM, Keith DA. Pseudogout in the temporomandibular joint with imaging, arthroscopic, operative, and pathologic findings. Report of an unusual case. J Oral Maxillofac Surg 2015; 73 (06) 1106-1112
  • 63 Kim K-A, Koh K-J. Recurrent simple bone cyst of the mandibular condyle: a case report. Imaging Sci Dent 2013; 43 (01) 49-53
  • 64 Saia G, Fusetti S, Emanuelli E, Ferronato G, Procopio O. Intraoral endoscopic enucleation of a solitary bone cyst of the mandibular condyle. Int J Oral Maxillofac Surg 2012; 41 (03) 317-320
  • 65 Ettl T, Ständer K, Schwarz S, Reichert TE, Driemel O. Recurrent aneurysmal bone cyst of the mandibular condyle with soft tissue extension. Int J Oral Maxillofac Surg 2009; 38 (06) 699-703
  • 66 Zadik Y, Aktaş A, Drucker S, Nitzan DW. Aneurysmal bone cyst of mandibular condyle: a case report and review of the literature. J Craniomaxillofac Surg 2012; 40 (08) e243-e248