Disk Displacement of the Temporomandibular Joint: Sonography Versus MR Imaging
Rüdiger Emshoff1,
Siegfried Jank1,
Stefan Bertram1,
Ansgar Rudisch2 and
Gerd Bodner2
1 Department of Oral and Maxillo-Facial Surgery, University of Innsbruck,
Maximilianstr. 10, A-6020 Innsbruck, Austria.
2 Department of Radiology, University of Innsbruck, Anichstr. 35, A-6020
Innsbruck, Austria.
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Fig. 1A. —Drawings illustrate examination and analysis of
temporomandibular joint (TMJ) disk position using high-resolution sonography.
Drawing shows technique of examining TMJ region with sonographic transducer
positioned against patient's face overlying zygomatic arch and TMJ.
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Fig. 1B. —Drawings illustrate examination and analysis of
temporomandibular joint (TMJ) disk position using high-resolution sonography.
Depiction of location of disk intermediate zone relative to condyle (C) and
articular eminence (E) at closed-mouth position. Top = anterior, left =
superior.
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Fig. 1C. —Drawings illustrate examination and analysis of
temporomandibular joint (TMJ) disk position using high-resolution sonography.
Depiction of location of disk intermediate zone relative to condyle (C) and
articular eminence (E) at maximal open-mouth position. Top = anterior, left =
superior.
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Fig. 2A. —Temporomandibular joint (TMJ) of 32-year-old woman. Diagnosis
of disk displacement with reduction was based on MR imaging findings.
Longitudinal high-resolution sonogram obtained in closed-mouth position shows
anterosuperior TMJ compartment and disk (arrows) anterior to condyle
(arrowheads). E = articular eminence, D = disk, C = condyle.
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Fig. 2B. —Temporomandibular joint (TMJ) of 32-year-old woman. Diagnosis
of disk displacement with reduction was based on MR imaging findings. Sagittal
MR image obtained in closed-mouth position shows anterosuperior TMJ
compartment and disk (arrows) anterior to condyle.
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Fig. 2C. —Temporomandibular joint (TMJ) of 32-year-old woman. Diagnosis
of disk displacement with reduction was based on MR imaging findings.
Longitudinal high-resolution sonogram obtained in maximal open-mouth position
shows anterosuperior TMJ compartment and disk (arrows) superior to
condyle (arrowheads). E = articular eminence, D = disk, C =
condyle.
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Fig. 2D. —Temporomandibular joint (TMJ) of 32-year-old woman. Diagnosis
of disk displacement with reduction was based on MR imaging findings. Sagittal
MR image obtained in maximal open-mouth position shows anterosuperior TMJ
compartment and disk (arrows) superior to condyle.
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Fig. 3A. —Temporomandibular joint (TMJ) in 27-year-old woman. Diagnosis
of disk displacement without reduction was based on MR imaging findings.
Longitudinal high-resolution sonogram shows anterosuperior TMJ compartment in
closed-mouth position and disk (arrows) anterior to condyle
(arrowheads). E = articular eminence, D = disk, C = condyle.
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Fig. 3B. —Temporomandibular joint (TMJ) in 27-year-old woman. Diagnosis
of disk displacement without reduction was based on MR imaging findings.
Sagittal MR image shows anterosuperior TMJ compartment in closed-mouth
position and disk (arrows) anterior to condyle.
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Fig. 3C. —Temporomandibular joint (TMJ) in 27-year-old woman. Diagnosis
of disk displacement without reduction was based on MR imaging findings.
Longitudinal high-resolution sonogram shows anterosuperior TMJ compartment in
maximal open-mouth position and disk (arrows) anterior to condyle
(arrowheads). E = articular eminence, D = disk, C = condyle.
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Fig. 3D. —Temporomandibular joint (TMJ) in 27-year-old woman. Diagnosis
of disk displacement without reduction was based on MR imaging findings.
Sagittal MR image shows anterosuperior TMJ compartment in maximal open-mouth
position and disk (arrows) anterior to condyle.
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Fig. 4. —Temporomandibular joint (TMJ) in 39-year-old man. Diagnosis
of disk displacement and degeneration was based on findings on MR imaging.
Interpretation of sonographic findings resulted in false-negative diagnosis.
Longitudinal high-resolution sonogram shows anterosuperior TMJ compartment
with disk disrupted in posterior (large arrows) and anterior
(small arrows) parts. Anterior part of disk (small arrows)
is displaced anteriorly to condyle (arrowheads). E = articular
eminence, D = disk, C = condyle.
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Fig. 5. —Temporomandibular joint (TMJ) in 21-year-old woman. Diagnosis
of medial disk displacement was based on findings on MR imaging.
Interpretation of sonographic findings resulted in false-negative diagnosis.
Longitudinal high-resolution sonogram shows anterosuperior TMJ compartment and
disk (arrows) superior to condyle (arrowheads). E =
articular eminence, D = disk, C = condyle.
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Fig. 6. —Temporomandibular joint (TMJ) in 35-year-old woman. MR
imaging showed normal disk position with effusion. Interpretation of
sonographic findings resulted in false-positive diagnosis. Longitudinal
high-resolution sonogram shows anterosuperior TMJ compartment with disk
(large arrows) superior to condyle (arrowheads) and presence
of effusion (small arrows). E = articular eminence, D = disk, C =
condyle, EF = effusion.
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Fig. 7. —Temporomandibular joint (TMJ) in 51-year-old woman. MR
imaging showed normal disk position and degeneration. Interpretation of
sonographic findings resulted in false-positive diagnosis. Longitudinal
high-resolution sonogram shows anterosuperior TMJ compartment with disk
(large arrows) superior to condyle (arrowheads) and presence
of fibrous structures (small arrows). E = articular eminence, D =
disk, C = condyle, F = fibrous structures.
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Copyright © 2002 by the American Roentgen Ray Society.
