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Arthrography of the Temporomandibular Joint and Arthrography-Guided Steroid Treatment

  • Eva Levring Jäghagen
  • Jan Ahlqvist
Chapter

Abstract

The aim of this chapter is to describe arthrography as method for diagnosing soft tissue derangements of the temporomandibular joint (TMJ) as well as a tool for guided administration of corticosteroids. The chapter includes numerous illustrations and five videos explaining the methods of arthrography, arthrotomography and contrast-guided administration of corticosteroids.

MRI is the most common method for diagnosing soft tissue derangements of the TMJ. Yet, there are situations when arthrography is useful and superior to MRI, e.g. when the patient suffers from claustrophobia, has loose ferromagnetic objects in the body or metal objects in the head and neck region causing disturbances in the images (e.g. orthodontic devices). Arthrography is also useful if there is call for diagnosing soft tissue perforations in the disc or the posterior attachment, or adherences between the disc or the posterior attachment and the bony components that can be revealed during the real-time dynamic assessment. Filling the joint compartments can contribute to loosening of adherences and the anaesthesia preceding injection of contrast media constitutes a diagnostic tool by confirming origin of pain. Follow-up of splint therapy can be included in the examination. Finally, arthrography can be used as guidance for intervention with, e.g. corticosteroids.

Keywords

Arthrography Arthrotomography TMJ Radiology Fluoroscopy Corticosteroid Disc displacement TMD (temporomandibular disorders) 

Notes

Acknowledgments

We would like to express our sincere gratitude to Dr. Per Erik Legrell and research engineer Magnus Johansson for their contributions to the illustrations.

Supplementary material

Video 16.1

(MP4 13752 kb)

Video 16.2

(MP4 11835 kb)

Video 16.3

(MP4 16891 kb)

Video 16.4

(MP4 35025 kb)

Video 16.5

(MP4 40919 kb)

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Oral and Maxillofacial Radiology, Department OdontologyUmeå UniversityUmeåSweden

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