MR imaging of internal derangements of the temporomandibular joint

The reliability and clinical diagnostic value of MR (Magnetic resonance) imaging were evaluated on the basis of the analytical results on surgical findings obtained from temporomandibular joints (TMJ) that had been studied preoperatively with MR imagings. In the past 16 months, 14 patients of 17 joints received a conventional open surgery or arthroscopic surgery. Preopereative MR imagings were obtained in all joints. 14 out of 17 joints showed a good agreement of predictive positive and negative findings with anterior disk displacement; six of the 17 joints had disk abnormal morphology; the remaining 11 joints showed negative findings of perforation. Disagreement of comparative findings was, however, found in four of the 17 joints in both disk morphology and perforation. Neither adhesive and inflammatory findings were predicted using MR imagings. Our findings suggest that MR imaging is useful for detection and evaluation of TMJ disk derangements, particularly in disk anterior displacement. Because of its non-irradiative diagnostic capacity, MR imaging has a superior value for diagnosis of uncomplicated internal dernagement of the TMJ. On the contrary, conventional arthrography was thought as an important procedure to detect a finding of intra-articular adhesion or perforation. (author)