Radiographic assessment of temporomandibular joint pain and dysfunction in the pediatric age-group

During a five-year period, a total of 150 patients (131 girls and 19 boys) with an average age of 14 years (range 7-16 years), with signs and symptoms of temporomandibular joint dysfunction were referred for imaging in the diagnostic radiology department. These patients were evaluated by multidirectional tomography to both joints, arthrography, computed tomography (CT), or magnetic resonance (MR) of one or both joints. Fifty-six (37 percent) of the 150 patients had plain tomographic, CT or MR evidence of degenerative arthritis of one or both sides (18/150 12 percent with bilateral degenerative joint disease). Internal derangements of the TMJ related to meniscal displacements and dysfunction were detected in 128 patients (85 percent). Twenty-nine patients (29/150: 20 percent) suffered from bilateral internal derangements. This clinical study demonstrates that internal derangements do occur in the pediatric age-group: the high percentages of both internal derangements and degenerative joint disease suggest a cautious clinical acceptance of imaging for internal derangements in the young patient. This reluctance to study these patients should be minimized by the new, noninvasive imaging modality available in magnetic resonance.