Skip to main content
SpringerLink
Log in
Book cover

Imaging of the Temporomandibular Joint pp 301–322Cite as

Arthrography of the Temporomandibular Joint and Arthrography-Guided Steroid Treatment

  • Chapter
  • First Online:

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.

This is a preview of subscription content, log in via an institution.

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   129.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD   169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  1. Zimmer EA. Die Röntgenologie des kiefergelenkes. Schweiz Monatsschr Zahnheilkd. 1941;51:12–24.

    Google Scholar 

  2. Nørgaard F. Athrography of the Mandibular Joint. Acta Radiol. 1944;25(5–6):679–85.

    Article  Google Scholar 

  3. Katzberg RW, Dolwick MF, Bales DJ, Helms CA. Arthro tomography of the temporomandibular joint: new technique and preliminary observations. AJR Am J Roentgenol. 1979;132:949–55.

    Article  CAS  Google Scholar 

  4. Wilkes CH. Arthrography of the temporomandibular joint in patients with the TMJ pain-dysfunction syndrome. Minn Med. 1978;61:645–52.

    CAS  PubMed  Google Scholar 

  5. Dolwick MF, Riggs RR. Diagnosis and treatment of internal derangements of the temporomandibular joint. Dent Clin N Am. 1983;27:561–72.

    CAS  PubMed  Google Scholar 

  6. Lundh H, Westesson P-L, Kopp S, Tillström B. Anterior repositioning splint in the treatment of temporomandibular joints with reciprocal clicking. Comparison with a flat occlusal splint and an untreated control group. Oral Surg. 1985;60:131–6.

    Article  CAS  Google Scholar 

  7. Arnaudow M, Haage H, Pflaum I. Die doppelkontrast arthrographie des kiefergelenkes. Dtsch Zahnartztl Z. 1968;23:390–3.

    CAS  Google Scholar 

  8. Ahlqvist J, Legrell PE. A technique for the accurate administration of corticosteroids in the temporomandibular joint. Technical report. DMFR. 1993;22:211–3.

    CAS  PubMed  Google Scholar 

  9. Katzberg RW, Westesson PL. Diagnosis of the temporomandibular joint. Philadelphia: WB Saunders; 1993.

    Google Scholar 

  10. Westesson P-L, Omnell KÅ, Rohlin M. Double-contrast tomography of the temporomandibular joint: a new technique based on autopsy specimen examinations. Acta Radiol. 1980;21:777–84.

    CAS  Google Scholar 

  11. Westesson P-L. Double-contrast arthrotomography of the temporomandibular joint: introduction of an arthrographic technique for visualization of the disk and articular surfaces. J Oral Maxillofac Surg. 1983;41:163–72.

    Article  CAS  Google Scholar 

  12. Westesson P-L, Bronstein SL. Temporomandibular joint: comparison of single- and double-contrast arthrography. Radiology. 1987;164:65–70.

    Article  CAS  Google Scholar 

  13. Ahlqvist J, Isberg A. Radiographic imaging. In: Isberg A, editor. Temporomandibular joint dysfunction: A practitioners guide p 187. Oxford: ISIS Medical Media Ltd; 2001. ISBN 1901865444.

    Google Scholar 

  14. Hollander JL, Brown EM Jr, Jessar RA, Brown CY. Hydrocortisone and Cortisone injected into arthritic joints. Comparative effects of and use of hydrocortisoe as a local antiarthritic agent. J Am Med Assoc. 1951;147(17):1629–35.

    Article  CAS  Google Scholar 

  15. Kopp S, Wennerberg B. Effects of occlusal treatment and intraarticular injections on temporomandibular joint pain and dysfunction. Acta Odontol Scand. 1981;39(2):87–96.

    Article  CAS  Google Scholar 

  16. Kopp S, Akerman S, Nilner M. Short-term effects of intra-articular sodium hyaluronate, glucocorticoid, and saline injections on rheumatoid arthritis of the temporomandibular joint. J Craniomandib Disord. 1991;5(4):231–8.

    CAS  PubMed  Google Scholar 

  17. Vallon D, Akerman S, Nilner M, Petersson A. Long-term follow-up of intra-articular injections into the temporomandibular joint in patients with rheumatoid arthritis. Swed Dent J. 2002;26(4):149–58.

    PubMed  Google Scholar 

  18. Stoustrup P, Kristensen KD, Verna C, Kuseler A, Pedersen TK, Herlin T. Intra-articular steroid injections for temporomandibular joint arthritis in juvenile idiopathic arthritis: A systematic review on efficacy and safety. Semin Arthritis Rheum. 2013;43(1):63–70.

    Article  CAS  Google Scholar 

  19. Tjakkes G-HE, TenVergert EM, de Bont LGM, Stegenga B. The effect of intra-articular injection of ultracain in the temporomandibular joint in patients with preauricular pain. A randomized prospective double-blind placebo-controlled crossover study. Clin J Pain. 2007;23:233–6.

    Article  Google Scholar 

  20. Renfrew DL, Moore TE, Kathol MH, El-Khoury GY, Lemke JH, Walker CW. Correct placement of epidural steroid injections: Fluoroscopic guidance and contrast administration. AJNR. 1991;12:1003–7.

    CAS  PubMed  Google Scholar 

  21. Stojanovic MP, Vu T-N, Caneris O, Slezak J, Cohen SP, Sang CN. The role of fluoroscopy in cervical epidural steroid injections. Spine. 2002;27(5):509–14.

    Article  Google Scholar 

  22. Björnland T, Gjaerum AA, Möystad A. Osteoarthritis of the temporomandibular joint: An evaluation of the effects and complications of corticosteroid injection compared with injection with sodium hyaluronate. J Oral Rehabil. 2007;34:583–9.

    Article  Google Scholar 

  23. Habib GS. Systemic effects of intra-articular corticosteroids. Clin Rheumatol. 2009;28(7):749–56.

    Article  Google Scholar 

Download references

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.

Author information

Authors and Affiliations

  1. Oral and Maxillofacial Radiology, Department Odontology, Umeå University, Umeå, Sweden

    Eva Levring Jäghagen & Jan Ahlqvist

Authors
  1. Eva Levring Jäghagen
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jan Ahlqvist
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Eva Levring Jäghagen .

Editor information

Editors and Affiliations

  1. Independent Unit of Propaedeutics of Dentomaxillofacial Radiology, Medical University of Lublin, Lublin, Poland

    Ingrid Rozylo-Kalinowska

  2. Faculty of Dentistry, Department of Dentomaxillofacial Radiology, Ankara University, Ankara, Turkey

    Kaan Orhan

16.1 Electronic Supplementary Material

(MP4 13752 kb)

(MP4 11835 kb)

(MP4 16891 kb)

(MP4 35025 kb)

(MP4 40919 kb)

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Levring Jäghagen, E., Ahlqvist, J. (2019). Arthrography of the Temporomandibular Joint and Arthrography-Guided Steroid Treatment. In: Rozylo-Kalinowska, I., Orhan, K. (eds) Imaging of the Temporomandibular Joint. Springer, Cham. https://doi.org/10.1007/978-3-319-99468-0_16

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-99468-0_16

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-99467-3

  • Online ISBN: 978-3-319-99468-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation