Abstract
Temporomandibular joint (TMJ) pathologies are numerous. This richly illustrated chapter focuses on the appropriate imaging and diagnostic criteria of the most frequent TMJ diagnoses being articular disc disorders and osteoarthritis, both of which affect adults and, to a lesser degree, children and adolescents. These conditions are thoroughly described and some controversies are discussed. Diagnostic imaging is a complement to anamnestic history and clinical examination, and its goal is to contribute to correct diagnosis and treatment. However, the risk versus the benefit of imaging must be regarded for each patient individually, even when a TMJ pathology or disturbance is clinically diagnosed or suspected. The imaging should have an expected impact on the treatment decision. This is particularly important, regarding patients with facial pain and mandibular dysfunction. It is widely accepted that the majority of those patients have masticatory muscle pain and joint imaging is usually not needed for management.
Keywords
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Morales H, Cornelius R. Imaging approach to temporomandibular joint disorders. Clin Neuroradiol. 2016;26(1):5–22.
Drace JE, Enzmann DR. Defining the normal temporomandibular joint: closed-, partially open, and open-mouth MR imaging of asymptomatic subjects. Radiology. 1990;177(1):67–71.
Schiffman E, Ohrbach R, Truelove E, Look J, Anderson G, Goulet JP, et al. Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) for Clinical and Research Applications: recommendations of the International RDC/TMD Consortium Network* and Orofacial Pain Special Interest Groupdagger. J Oral Facial Pain Headache. 2014;28(1):6–27.
Larheim TA. Current trends in temporomandibular joint imaging. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1995;80(5):555–76.
Katzberg RW, Westesson PL, Tallents RH, Drake CM. Anatomic disorders of the temporomandibular joint disc in asymptomatic subjects. J Oral Maxillofac Surg. 1996;54(2):147–53. discussion 53–5
Tasaki MM, Westesson PL, Isberg AM, Ren YF, Tallents RH. Classification and prevalence of temporomandibular joint disk displacement in patients and symptom-free volunteers. Am J Orthod Dentofac Orthop. 1996;109(3):249–62.
Ribeiro RF, Tallents RH, Katzberg RW, Murphy WC, Moss ME, Magalhaes AC, et al. The prevalence of disc displacement in symptomatic and asymptomatic volunteers aged 6 to 25 years. J Orofac Pain. 1997;11(1):37–47.
Larheim TA, Westesson P, Sano T. Temporomandibular joint disk displacement: comparison in asymptomatic volunteers and patients. Radiology. 2001;218(2):428–32.
Annandale T. On displacement of the inter-articular cartilage of the lower jaw, and its treatment by operation. Lancet. 1887;129(3313):411.
Farrar WB, McCarty WL Jr. Inferior joint space arthrography and characteristics of condylar paths in internal derangements of the TMJ. J Prosthet Dent. 1979;41(5):548–55.
Kircos LT, Ortendahl DA, Mark AS, Arakawa M. Magnetic resonance imaging of the TMJ disc in asymptomatic volunteers. J Oral Maxillofac Surg. 1987;45(10):852–4.
Turp JC, Schlenker A, Schroder J, Essig M, Schmitter M. Disk displacement, eccentric condylar position, osteoarthrosis - misnomers for variations of normality? Results and interpretations from an MRI study in two age cohorts. BMC Oral Health. 2016;16(1):124.
Westesson PL, Eriksson L, Kurita K. Reliability of a negative clinical temporomandibular joint examination: prevalence of disk displacement in asymptomatic temporomandibular joints. Oral Surg Oral Med Oral Pathol. 1989;68(5):551–4.
Rammelsberg P, Pospiech PR, Jager L, Pho Duc JM, Bohm AO, Gernet W. Variability of disk position in asymptomatic volunteers and patients with internal derangements of the TMJ. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1997;83(3):393–9.
Kerstens HC, Golding RP, Valk J, van der Kwast WA. Magnetic resonance imaging of partial temporomandibular joint disc displacement. J Oral Maxillofac Surg. 1989;47(1):25–9.
Tominaga K, Konoo T, Morimoto Y, Tanaka T, Habu M, Fukuda J. Changes in temporomandibular disc position during growth in young Japanese. Dentomaxillofac Radiol. 2007;36(7):397–401.
Hasegawa Y, Kakimoto N, Tomita S, Fujiwara M, Ishikura R, Kishimoto H, et al. Evaluation of the role of splint therapy in the treatment of temporomandibular joint pain on the basis of MRI evidence of altered disc position. J Cranio-Maxillofac Surg. 2017;45(4):455–60.
Ahmad M, Hollender L, Anderson Q, Kartha K, Ohrbach R, Truelove EL, et al. Research diagnostic criteria for temporomandibular disorders (RDC/TMD): development of image analysis criteria and examiner reliability for image analysis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009;107(6):844–60.
Larheim TA, Katzberg RW, Westesson PL, Tallents RH, Moss ME. MR evidence of temporomandibular joint fluid and condyle marrow alterations: occurrence in asymptomatic volunteers and symptomatic patients. Int J Oral Maxillofac Surg. 2001;30(2):113–7.
Larheim TA, Westesson PL, Sano T. MR grading of temporomandibular joint fluid: association with disk displacement categories, condyle marrow abnormalities and pain. Int J Oral Maxillofac Surg. 2001;30(2):104–12.
Schellhas KP, Wilkes CH. Temporomandibular joint inflammation: comparison of MR fast scanning with T1- and T2-weighted imaging techniques. AJR Am J Roentgenol. 1989;153(1):93–8.
Schellhas KP, Wilkes CH, Fritts HM, Omlie MR, Lagrotteria LB. MR of osteochondritis dissecans and avascular necrosis of the mandibular condyle. AJR Am J Roentgenol. 1989;152(3):551–60.
Larheim TA, Westesson PL, Hicks DG, Eriksson L, Brown DA. Osteonecrosis of the temporomandibular joint: correlation of magnetic resonance imaging and histology. J Oral Maxillofac Surg. 1999;57(8):888–98. discussion 99
Hamblen DL, Simpson AHRW, Adams JC, Raby N. Adams’s outline of orthopaedics. 14th ed. Edinburgh: Churchill Livingstone Elsevier; 2010.
Rao VM, Liem MD, Farole A, Razek AA. Elusive “stuck” disk in the temporomandibular joint: diagnosis with MR imaging. Radiology. 1993;189(3):823–7.
da Silva CG, Pacheco-Pereira C, Porporatti AL, Savi MG, Peres MA, Flores-Mir C, et al. Prevalence of clinical signs of intra-articular temporomandibular disorders in children and adolescents: a systematic review and meta-analysis. J Am Dent Assoc. 2016;147(1):10–8.e8.
Katzberg RW, Tallents RH, Hayakawa K, Miller TL, Goske MJ, Wood BP. Internal derangements of the temporomandibular joint: findings in the pediatric age group. Radiology. 1985;154(1):125–7.
Ikeda K, Kawamura A, Ikeda R. Prevalence of disc displacement of various severities among young preorthodontic population: a magnetic resonance imaging study. J Prosthodont. 2014;23(5):397–401.
Paesani D, Salas E, Martinez A, Isberg A. Prevalence of temporomandibular joint disk displacement in infants and young children. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1999;87(1):15–9.
Loeser RF, Goldring SR, Scanzello CR, Goldring MB. Osteoarthritis: a disease of the joint as an organ. Arthritis Rheum. 2012;64(6):1697–707.
Berenbaum F. Osteoarthritis as an inflammatory disease (osteoarthritis is not osteoarthrosis!). Osteoarthr Cartil. 2013;21(1):16–21.
World Health Organization (WHO). Chronic diseases and health promotion 2017. Available from: http://www.who.int/chp/topics/rheumatic/en/
Abrahamsson AK, Kristensen M, Arvidsson LZ, Kvien TK, Larheim TA, Haugen IK. Frequency of temporomandibular joint osteoarthritis and related symptoms in a hand osteoarthritis cohort. Osteoarthr Cartil. 2017;25(5):654–7.
Alexiou K, Stamatakis H, Tsiklakis K. Evaluation of the severity of temporomandibular joint osteoarthritic changes related to age using cone beam computed tomography. Dentomaxillofac Radiol. 2009;38(3):141–7.
Stegenga B. Osteoarthritis of the temporomandibular joint organ and its relationship to disc displacement. J Orofac Pain. 2001;15(3):193–205.
Larheim TA, Westesson P-LA. Maxillofacial imaging. Berlin: Springer; 2018.
Wang XD, Zhang JN, Gan YH, Zhou YH. Current understanding of pathogenesis and treatment of TMJ osteoarthritis. J Dent Res. 2015;94(5):666–73.
Peck CC, Goulet JP, Lobbezoo F, Schiffman EL, Alstergren P, Anderson GC, et al. Expanding the taxonomy of the diagnostic criteria for temporomandibular disorders. J Oral Rehabil. 2014;41(1):2–23.
Ahmad M, Schiffman EL. Temporomandibular joint disorders and orofacial pain. Dent Clin North Am. 2016;60(1):105–24.
Larheim TA. Role of magnetic resonance imaging in the clinical diagnosis of the temporomandibular joint. Cells Tissues Organs. 2005;180(1):6–21.
Westesson PL, Katzberg RW, Tallents RH, Sanchez-Woodworth RE, Svensson SA. CT and MR of the temporomandibular joint: comparison with autopsy specimens. AJR Am J Roentgenol. 1987;148(6):1165–71.
Larheim TA, Abrahamsson AK, Kristensen M, Arvidsson LZ. Temporomandibular joint diagnostics using CBCT. Dentomaxillofac Radiol. 2015;44(1):20140235.
Larheim TA, Kolbenstvedt A. High-resolution computed tomography of the osseous temporomandibular joint. Some normal and abnormal appearances. Acta Radiol Diagn (Stockh). 1984;25(6):465–9.
Koyama J, Nishiyama H, Hayashi T. Follow-up study of condylar bony changes using helical computed tomography in patients with temporomandibular disorder. Dentomaxillofac Radiol. 2007;36(8):472–7.
Jacobson JA, Girish G, Jiang Y, Sabb BJ. Radiographic evaluation of arthritis: degenerative joint disease and variations. Radiology. 2008;248(3):737–47.
Haugen IK, Slatkowsky-Christensen B, Boyesen P, van der Heijde D, Kvien TK. Cross-sectional and longitudinal associations between radiographic features and measures of pain and physical function in hand osteoarthritis. Osteoarthr Cartil. 2013;21(9):1191–8.
Smith HJ, Larheim TA, Aspestrand F. Rheumatic and nonrheumatic disease in the temporomandibular joint: gadolinium-enhanced MR imaging. Radiology. 1992;185(1):229–34.
Farina D, Bodin C, Gandolfi S, De Gasperi W, Borghesi A, Maroldi R. TMJ disorders and pain: assessment by contrast-enhanced MRI. Eur J Radiol. 2009;70(1):25–30.
Sanchez-Woodworth RE, Katzberg RW, Tallents RH, Guay JA. Radiographic assessment of temporomandibular joint pain and dysfunction in the pediatric age-group. ASDC J Dent Child. 1988;55(4):278–81.
Cho BH, Jung YH. Osteoarthritic changes and condylar positioning of the temporomandibular joint in Korean children and adolescents. Imaging Sci Dent. 2012;42(3):169–74.
Wang ZH, Jiang L, Zhao YP, Ma XC. Investigation on radiographic signs of osteoarthrosis in temporomandibular joint with cone beam computed tomography in adolescents. Beijing Da Xue Xue Bao. 2013;45(2):280–5.
Lei J, Han J, Liu M, Zhang Y, Yap AU, Fu KY. Degenerative temporomandibular joint changes associated with recent-onset disc displacement without reduction in adolescents and young adults. J Craniomaxillofac Surg. 2017;45(3):408–13.
Lei J, Liu MQ, Yap AU, Fu KY. Condylar subchondral formation of cortical bone in adolescents and young adults. Br J Oral Maxillofac Surg. 2013;51(1):63–8.
Arnett GW, Milam SB, Gottesman L. Progressive mandibular retrusion--idiopathic condylar resorption. Part I. Am J Orthod Dentofac Orthop. 1996;110(1):8–15.
Papadaki ME, Tayebaty F, Kaban LB, Troulis MJ. Condylar resorption. Oral Maxillofac Surg Clin North Am. 2007;19(2):223–34, vii.
Nickerson JW, Boring G. Natural course of osteoarthrosis as it relates to internal derangement of the temporomandibular joint. Oral Maxillofac Surg Clin North Am. 1989;1:27–45.
Wolford LM, Galiano A. Adolescent internal condylar resorption (AICR) of the temporomandibular joint, part 1: a review for diagnosis and treatment considerations. Cranio. 2017. https://doi.org/10.1080/08869634.2017.1386752.
Kristensen KD, Schmidt B, Stoustrup P, Pedersen TK. Idiopathic condylar resorptions: 3-dimensional condylar bony deformation, signs and symptoms. Am J Orthod Dentofac Orthop. 2017;152(2):214–23.
Arnett GW, Gunson MJ. Risk factors in the initiation of condylar resorption. Semin Orthod. 2013;19(2):81–8.
Hatcher DC. Progressive condylar resorption: pathologic processes and imaging considerations. Semin Orthod. 2013;19(2):97–105.
Burke PH. A case of acquired unilateral mandibular condylar hypoplasia. Proc R Soc Med. 1961;54:507–10.
Rabey GP. Bilateral mandibular condylysis-a morphanalytic diagnosis. Br J Oral Surg. 1977;15(2):121–34.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2019 Springer Nature Switzerland AG
About this chapter
Cite this chapter
Larheim, T.A., Mork-Knutsen, B.B., Hol, C., Abrahamsson, AK., Ottersen, M.K., Arvidsson, L.Z. (2019). TMJ Disc Disorders and Osteoarthritis. In: Rozylo-Kalinowska, I., Orhan, K. (eds) Imaging of the Temporomandibular Joint. Springer, Cham. https://doi.org/10.1007/978-3-319-99468-0_13
Download citation
DOI: https://doi.org/10.1007/978-3-319-99468-0_13
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-99467-3
Online ISBN: 978-3-319-99468-0
eBook Packages: MedicineMedicine (R0)