Imaging of the temporomandibular joint

Both arthrography and MR imaging are of proven value in the evaluation of internal derangements of the TMJ. Arthrography provides the advantages of a dynamic display of joint mechanics and the easy detection of disc perforation. Its disadvantages include its technical difficulty and its poor visualization of the disc in the medial-lateral plane. MR imaging of the TMJ provides excellent soft-tissue detail and more readily demonstrates medial and lateral displacements of the disc. Unfortunately, perforations of the disc or ligaments are not usually visualized, and bony detail is not seen as well as on plain radiographs or computed tomography. In addition, real-time dynamic imaging of joint mechanics is not readily available. Currently, the choice of imaging modality is based on the specific diagnostic question, and availability of arthrography and MR imaging.