Imaging of the temporomandibular joint

Imaging of the temporomandibular joint recently has been characterized by a shift in emphasis from plain films, arthrography, and computed tomography toward magnetic resonance imaging. The past year represents the continuation of the era of refinement in magnetic resonance technology not immediately obvious as an advantage for temporomandibular joint imaging but nonetheless, of potential significant impact. A few examples of relatively "quiet" developments include: 1) new alloys for lighter weight permanent magnets with reduced operating costs; 2) gradient coil technology for more rapid image acquisition leading to the possibility of true cine magnetic resonance; and 3) smaller, more powerful computers for more rapid data processing. The implications are for comprehensive anatomic and physiologic assessments of the joint along with increased patient throughput and reduced costs. This review surveys the recent literature on the techniques and selection of imaging modalities, new observations regarding the pathophysiology of temporomandibular joint diseases afforded by advances in imaging technology, and my opinions regarding future directions in imaging technology based on my own experience and a review of the current literature.