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18b - Answer: 63-year-old male presents with capsulitis of temporomandibular joint

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

HISTORY: 

This 63-year-old male presents with capsulitis of temporomandibular joint.

(QUIZ ANSWER) NOT A FINDING IN THIS CASE: 

Left TMJ: Normal condylar head.

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

FINDINGS:

The left TMJ shows severe arthropathic changes with collapse of the condylar head and associated osteosclerosis all raising the suspicion of chronic osteonecrosis-related changes. There is anterior dislocation of the left TMJ disc. On the open-mouth views, there is normal translation of the condylar head. The disc remains anteriorly dislocated. 

The right TMJ shows a normal condylar head, condylar fossa and articular eminence. There is anterior dislocation of the disc. On the open-mouth views, there is normal translation of the condylar head and normal capture of the disc. 

CONCLUSION: 

1. The right TMJ shows anterior dislocation of the disc with normal translation of the condylar head on the open-mouth views and normal capture of the disc. 

2. The left TMJ shows severe arthropathic changes with collapse of the condylar head and associated osteosclerosis all raising the suspicion of chronic osteonecrosis-related changes with anterior dislocation of the disc with normal translation of the condylar head on the open-mouth views with the disc remaining anteriorly dislocated on the open-mouth views.

LESSON 2, TOPIC 54

Case Challenge: Temporomandibular Joint (TMJ) MRI Cases

Case Challenge

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Content reviewed: August 31, 2021

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