46-year-old female with history of locking and popping jaw for 15 years

Case
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46-year-old female with popping and locking of the left jaw for 15 years worsening since August with slight improvement after therapy and steroids. Evaluate for disc dislocation and capsulitis.

Long- and short-axis fat- and water-weighted images were performed. 

  • Visualized intracranial structures are unremarkable. Visualized portions of the globes and orbits are within normal limits. Mucosal thickening of the right maxillary sinus is noted. 
  • RIGHT TEMPOROMANDIBULAR JOINT:
    • In the closed position the meniscus or articular disc is displaced anteriorly. The posterior bands of the disc are stretched but are not definitely torn. The condylar head is remodeled with small erosions noted. On opening the articular disc is displaced anteriorly and there is no recapture. 
  • LEFT TEMPOROMANDIBULAR JOINT:
    • The articular disc is displaced anteriorly. The condylar head is eroded and flattened with chondromalacia and pseudocyst formation. Articular disc is degenerated. The posterior attachment of the articular disc is ruptured. On open-mouth view the articular disc translates anteriorly and there is no evidence for recapture. 
  • Lymphoepithelial cyst noted of the parotid glands as an incidental finding.
  • Bilateral dislocated articular discs without recapture on mouth opening. Condylar head remodeling flattening and chondromalacia more severe involving the left as opposed to the right. The posterior attachments of the right articular disc are still intact although stretched while the posterior attachments of the left disc are torn. 
  • Lymphoepithelial cysts of the parotid glands and sinus mucosal disease as described above as incidental findings.