Temporomandibular joint: comparison of MR images with cryosectional anatomy

The accuracy of magnetic resonance (MR) imaging in the assessment of internal derangements of the temporomandibular joint (TMJ) has not been systematically evaluated. We obtained multiple 3-mm-thick sagittal and coronal MR images of 15 fresh TMJ autopsy specimens and compared the MR imaging findings with observations in corresponding sagittal cryosections. MR imaging correctly delineated the position of the disk in 11 (73%) joints and incorrectly delineated it in four (27%) joints. Disk configuration was depicted accurately in nine (60%) joints, inaccurately in five (33%), and was not visible in one (7%). Errors observed with sagittal MR images were correlated with mediolateral alterations of disk position. These abnormalities were depicted in coronal images, however. Osseous anatomy was correctly assessed in nine joints (60%). MR imaging demonstrated the margin between the disk and its attachments, which is not possible by arthrography. MR imaging is an acceptable alternative to other imaging modalities for assessing soft and hard tissues of the TMJ.