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14b - Answer: 49-year-old female presents with bilateral jaw pain

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

HISTORY: 

This 49-year-old female presents with bilateral jaw pain with jaw locking up, left greater than right, for one year.

(QUIZ ANSWER) PRIMARY FINDING(S) IN THIS CASE: 

All 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:

Right: Flattening of the mandibular condyle noted with tiny erosive changes consistent with arthrosis. Moderate capsulitis is seen. The condylar fossa is within normal limits. The condylar eminence is without abnormality. Anterior displacement of the disc noted in the closed-mouth position. No evidence of recapture in the open-mouth position. 

Left: Flattening of the mandibular condyle noted with anterior osteophyte formation. The mandibular condyle is in anatomic alignment with the condylar fossa in the closed-mouth position. Anterior displacement of the disc noted. No evidence of recapture on the open-mouth position. 

Ethmoid sinus mucosal thickening noted consistent with sinusitis. 

CONCLUSION: 

1. Moderate bilateral TMJ arthrosis, complete derangements with anterior disc displacement and no evidence of recapture on either side left greater than right. Forced translation. Left displacement 80 degrees closed mouth and right 60 degrees closed mouth.

2. Ethmoid sinusitis.

LESSON 2, TOPIC 42

Case Challenge: Temporomandibular Joint (TMJ) MRI Cases

Case Challenge

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Content reviewed: August 31, 2021

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