Normal and abnormal temporomandibular joints as demonstrated by magnetic resonance imaging

Magnetic resonance imaging of the temporomandibular joint (TMJ) was performed on two normal volunteer subjects and two symptomatic subjects using a 0.15 T resistive magnet. A spin echo pulse sequence with a TE of 38 ms and a TR of 500 ms was employed. The TMJ meniscus is a low signal structure, and the bilaminar zone behind it is a relatively high signal structure. In normal closed mouths, the demarcation between meniscus and bilaminar zone is located at the vertex position above the mandibular condyle. When the condyle translates, the posterior portion of the meniscus bulges into the joint space. Dislocated meniscus can be identified by a gray mass anterior to the condylar head. The joint space is filled with the higher signal of the bilaminar zone. In non-reducible dislocations, the meniscus remains anterior to the condylar head with opening of the mouth. Reduced dislocations appear similar to normal joints in the open mouth.