Indication for and accuracy of CT and MRI of the temporomandibular joint

Recurrent pains of the temporomandibular joint represent a frequent symptom with numerous different causes. CT and MRI can reliably show the cause of these disorders and therefore have substituted conventional X-ray imaging. Modern multi-slice-CT (MSCT) allows for examination of the skull base including the mandible in a very short time with thinnest slice collimation (0.75 mm). With 2D- and 3D- reformations reconstructed out of this volume data set in parasagittal, coronal or any other arbitrary slice orientation excellent imaging of fractures and bony changes of arthrosis as well as benign and malignant tumors of the temporomandibular joint can be performed. MRI offers very good soft tissue contrast in order to visualize the intra-articular disc, the ligaments and muscles, as well the possibility to acquire cross sectional images in any user-defined orientation. MRI is the method of choice to diagnose 'internal derangement', particularly displacement of the intra-articular disc and inflammatory disease of the temporomandibular joint. The present paper will provide diagnostic strategies for the use of MSCT or MRI imaging concerning the different causes of disorders to the temporomandibular joint. (orig.)