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9b - Answer: 31-year-old female presents with severe headaches and jaw clicking

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

HISTORY: 

This 31-year-old female presents with severe headaches and jaw clicking for five months.

(QUIZ ANSWER) NOT A FINDING IN THIS CASE: 

Left TMJ: Mandibular condyle is normal in contour.

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 normal in contour. No high grade arthrosis noted. The condylar eminence and fossa are within normal limits. No joint fluid seen. 

Grade 3-4 American Dental Association Criteria right meniscal displacement without capture, a complete internal derangement with diminished translation

The bone marrow signal is within normal limits. 

Left: Slight irregularity of the mandibular condyle is seen with a tiny erosion consistent with arthrosis. The condylar eminence and fossa are within normal limits. No joint effusion seen. 

The disc is displaced anteriorly in the closed-mouth position but is normal in shape and intact. 

Partial anterior translation of the condyle is seen with recapture of the disc. 

The bone marrow signal is normal. 

IMPRESSION:

Left TMJ dysfunction with anterior disc displacement and partial translation with recapture.

Left mandibular condyle arthrosis.

Grade 3-4 American Dental Association Criteria right meniscal displacement without capture, a complete internal derangement with diminished translation.

LESSON 2, TOPIC 27

Case Challenge: Temporomandibular Joint (TMJ) MRI Cases

Case Challenge

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Content reviewed: August 31, 2021

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