Determination of normal post-mortem computed tomography (PMCT) parameters for the temporomandibular joint

Area of Science:

• Forensic Radiology
• Anatomical Pathology

Background:

• Post-mortem computed tomography (PMCT) is vital for forensic death investigation.
• Interpreting PMCT requires understanding post-mortem anatomical changes to differentiate artifacts from pathology.

Purpose of the Study:

• To define normal temporomandibular joint (TMJ) configuration in post-mortem CT scans.
• To introduce and validate the TMJ PAT (perpendicular assessment tool) for assessing condyle-eminence relationships.

Main Methods:

• Retrospective analysis of PMCT scans from 100 non-decomposed, non-traumatic adult deaths.
• Bilateral assessment of TMJ configuration using the TMJ PAT measurement method.

Main Results:

• In 99% of cases, the mandibular condyle apex was positioned at or posterior to the articular eminence.
• A positive TMJ PAT measurement, indicating anterior condylar displacement, suggests pathology like TMJ dislocation (TMJD).

Conclusions:

• The TMJ PAT tool reliably distinguishes normal from abnormal TMJ configurations in post-mortem imaging.
• This method enhances forensic pathology practice, aiding accurate death investigations, even in resource-limited settings.