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TMJ
Imaging
| The temporomandibular
joint (TMJ) is the small jaw joint located in front
of the ear. |
| The
TMJ can cause problems if the disk gets displaced from it's
normal position on top of the mandibular condyle. |
TMJ
Pathophysiology
Symptoms
and imaging: Clinical
symptoms are often pain, clicking, locking, and limitation
of opening. The best imaging technique to study the TMJ
is MR imaging. MR demonstrates the bone and the soft tissue,
and especially the disk can be seen. TMJ MR imaging is
totally noninvasive and requires no injections.
Muscular
pain versus joint pain: It is important to understand
the difference of pain coming from the muscles of mastication
or pain coming from the jaw joint (TMJ). Physical examination
and imaging are helpful to make this differentiation.
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Plain
Film
Plain
films are used primarily to evaluate for bone disease such
as osteoarthritis and traumatic injuries.
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Arthrography
TMJ
arthrography, once a mainstay in diagnosis of TMJ disease,
is not used extensively anymore since noninvasive MR imaging
has replaced it.
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Treatment: Muscle
symptoms are obviously not treated with surgery whereas occasionally
joint disorders caused by derangement/internal derangement
may be treated by surgery.
The etiology of
TMJ pain and dysfunction is unknown. It is thought that in
some cases it is caused by trauma, but many cases have no
clear etiology.
The
diagnosis is made by physical examination often assisted
with imaging.
Remarks: Not
all patients with pain in front of the ear or facial pain
have TMJ disease. Many patients with true internal derangement
also have muscle pain.
Physical
therapy, rehabilitation, and muscle treatment are probably
the most important conservative measures. |
Additional information can be found at http://www.ada.org/public/topics/tmd.html.
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