Multidetector computed tomography of temporomandibular joint: A road less travelled

Abstract

This article reviews the imaging anatomy of temporomandibular joint (TMJ), describes the technique of multi-detector computed tomography (MDCT) of the TMJ, and describes in detail various osseous pathologic afflictions affecting the joint. Traumatic injuries affecting the mandibular condyle are most common, followed by joint ankylosis as a sequel to arthritis. The congenital anomalies are less frequent, hemifacial microsomia being the most commonly encountered anomaly involving the TMJ. Neoplastic afflictions of TMJ are distinctly uncommon, osteochondroma being one of the most common lesions. MDCT enables comprehensive evaluation of osseous afflictions of TMJ, and is a valuable tool for surgical planning. Sagittal, coronal and 3D reformatted images well depict osseous TMJ lesions, and their relationship to adjacent structures.

Keywords: Temporomandibular joint; Temporomandibular joint trauma; Congenital anomalies of temporomandibular joint; Temporomandibular joint arthritis; Multi-detector computed tomography

Core tip: This pictorial review describes the common as well as uncommon bony afflictions of the temporomandibular joint (TMJ) with classical images. Bony afflictions of the TMJ constitute a significant bulk of lesions around this joint. However, very little literature is available on imaging evaluation of non-articular disc, osseous disorders. Computed tomography (CT) is the workhorse for evaluation of osseous lesions around the joint and this article focuses on the CT evaluation of these lesions, and also on optimal imaging strategy, which is essential for surgical planning.