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16b - Answer: 63-year-old female presents with right temporomandibular joint pain

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

HISTORY: 

This 63-year-old female presents with right temporomandibular joint pain, which has been worsening in the past month.

(QUIZ ANSWER) IS A FINDING IN THIS CASE: 

Right TMJ: Osteoarthritis with flattening and irregularity of the condyle and moderate effusion.

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

FINDINGS: 

Right: The mandibular condyle is slightly irregular. The mandibular fossa and articular eminence are normal in contour. Moderate joint effusion noted. 

Anterior disc displacement is seen with deformity of the disc. 

Anterior translation with partial recapture of the disc noted in the open mouth position. 

Left: The mandibular condyle is normal in contour. The mandibular fossa and articular eminence are within normal limits. Minimal joint effusion seen.

The disc is in anatomic alignment in the closed mouth position. Normal morphology noted.

Anterior translation of the disc noted. However, the mandibular condyle appears to be dislocated anterolaterally in the open mouth position. 

The bone marrow signal is within normal limits. 

No soft tissue abnormalities. 

CONCLUSION: 

1. Right internal derangement; anterior displacement and deformity of the disc with partial recapture only. Reduced condylar translation.

2. Normal position and morphology of the left disc with concern for anterolateral subluxation of the condyle in the open mouth position. 

3. Osteoarthritis, moderate, of the right TMJ with flattening and irregularity of the condyle and moderate effusion. 

4. Minimal effusion of the left TMJ.

LESSON 2, TOPIC 48

Case Challenge: Temporomandibular Joint (TMJ) MRI Cases

Case Challenge

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Content reviewed: August 31, 2021

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