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11b - Answer: 66-year-old female presents with bilateral temporomandibular joint dislocation

Pomeranz, Stephen
Stephen J Pomeranz, MD
Chief Medical Officer, ProScan Imaging. Founder, MRI Online
Includes DICOM files

HISTORY: 

This 66-year-old female presents with bilateral temporomandibular joint dislocation. Patient is unable to open her mouth since dental procedure two months prior. Severe decreased range of motion of the jaw. No history of surgery to the temporomandibular joints.

(QUIZ ANSWER) IS A FINDING IN THIS CASE: 

None of the above.

Using the diagnostic web viewer, we have provided images that assist in telling our clinical story. Areas of significance are indicated below.

FINDINGS:

LEFT:

Condylar head is normally shaped and in normal location within the condylar fossa.

Condylar fossa is normally shaped and the articular eminence is not flattened.

No evidence of osteoarthritic spurring, capsular distention, TMJ ligament thickening or synovitis.

No evidence of avascular necrosis.

Medial and lateral positioning of the condylar head is normal.

Parapharyngeal and masticator spaces are normal.

No entrapped masses or abnormalities sitting within the condylar fossa preventing the condyle from lying in the normal joint space or cavity are noted.

Articular disc is slightly displaced on closed-mouth imaging approximately 11:00 position and is relatively normal.

Meniscal shape and signal intensity is normal.

On open-mouth imaging, mandibular condyle remains within the condylar fossa compatible with closed lock.

RIGHT:

Condylar head is normally shaped and in normal location within the condylar fossa.

Condylar fossa is normally shaped and the articular eminence is not flattened.

No evidence of osteoarthritic spurring, capsular distention, TMJ ligament thickening or synovitis.

No evidence of avascular necrosis.

Medial and lateral positioning of the condylar head is normal.

Parapharyngeal and masticator spaces are normal.

No entrapped masses or abnormalities sitting within the condylar fossa preventing the condyle from lying in the normal joint space or cavity are noted.

Articular disc is normally located approximately at the 12 o'clock position.

Meniscal shape and signal intensity is normal.

On open-mouth imaging, mandibular condyle remains within the condylar fossa compatible with closed lock.

CONCLUSION:

Mandibular condyles remain within the condylar fossa on open-mouth imaging compatible with closed lock. Articular discs are normal in position on closed-mouth imaging. No evidence of entrapped mass.

LESSON 2, TOPIC 33

Case Challenge: Temporomandibular Joint (TMJ) MRI Cases

Case Challenge

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Content reviewed: August 31, 2021

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