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Normal magnetic resonance appearances of the temporomandibular joints in children and young adults aged 2–18 years

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Abstract

Background

Knowledge of normal appearances of the temporomandibular joint (TMJ) is paramount when assessing the joint for disease in juvenile idiopathic arthritis. Reliable features defining normal TMJs in children are limited.

Objective

To establish reliable normal standards for the TMJ at magnetic resonance imaging (MRI).

Materials and methods

We included children and young adults aged 2–18 years undergoing a head MRI for reasons not believed to affect the TMJs. We assessed TMJ anatomy and contrast enhancement using a high-resolution 3-D T1-weighted sequence. We noted joint fluid and bone marrow oedema based on a T2-weighted sequence. Three experienced radiologists read all examinations twice in consensus and defined intraobserver consensus agreement.

Results

We evaluated the TMJs in 101 children and young adults (45 female), mean age 10.7 years (range 2–18 years). The intraobserver consensus agreement for the assessment of anterior condylar inclination in the sagittal/oblique plane was moderate to good (Cohen κ=0.7 for the right side). Cohen κ for intraobserver consensus agreement for condylar shape in the coronal plane on a 0–2 scale was 0.4 for the right and 0.6 for the left. Intraobserver agreement for measurement of joint space height and assessment of bone marrow oedema was poor. There was a statistically significant increase in anterior inclination by age in the sagittal plane on a 0–2 scale (P<0.0001). Eighty percent of the condyles showed a rounded shape in the coronal plane while 20% showed mild flattening. Thirty-five of 36 right TMJs showed contrast enhancement (mild enhancement in 32 joints, moderate in 3 joints).

Conclusion

Subjective assessment of the anterior condylar inclination in the sagittal/oblique plane and condylar flattening in the coronal plane can be considered precise features for describing TMJ anatomy in healthy children. There is an increasing anterior inclination by age. Mild contrast enhancement of the TMJs should be considered a normal finding.

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Acknowledgements

Parts of this study were funded by the Liaison Committee between the Central Norway Regional Health Authority (RHA) and the Norwegian University of Science and Technology (NTNU).

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Authors and Affiliations

  1. Department of Radiology and Nuclear Medicine,St Olav Hospital HF, Trondheim University Hospital, Postboks 3250, Sluppen, 7006, Trondheim, Norway

    Oskar W. Angenete

  2. Department of Circulation and Medical imaging,Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway

    Oskar W. Angenete & Marite Rygg

  3. Department of Radiology, University Hospital of North Norway, Tromsø, Norway

    Thomas A. Augdal

  4. Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway

    Thomas A. Augdal

  5. Department of Radiology, Haukeland University Hospital, Bergen, Norway

    Stig Jellestad

  6. Department of Pediatrics, St. Olavs Hospital, Trondheim, Norway

    Marite Rygg

  7. Department of Clinical Medicine, University of Bergen, Bergen, Norway

    Karen Rosendahl

  8. Department of Radiology, Haukeland University hospital, Bergen, Norway

    Karen Rosendahl

Authors
  1. Oskar W. Angenete
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  2. Thomas A. Augdal
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  3. Stig Jellestad
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  4. Marite Rygg
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Correspondence to Oskar W. Angenete.

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Angenete, O.W., Augdal, T.A., Jellestad, S. et al. Normal magnetic resonance appearances of the temporomandibular joints in children and young adults aged 2–18 years. Pediatr Radiol 48, 341–349 (2018). https://doi.org/10.1007/s00247-017-4048-x

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  • DOI: https://doi.org/10.1007/s00247-017-4048-x

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