INVESTIGATIONS IN TMJ DYSFUNCTION
Various imaging modalities are available to assess the degree of joint destruction and dysfunction. The main modality used is MRI imaging. An inflammatory screening process can be used to help rule out inflammatory conditions such as rheumatoid arthritis.
Other imaging modalities that are very useful are CT and Bone Scan when indicated.
Certain blood tests are used to help rule out or diagnose conditions such as Rheumatoid Arthritis. Often inflammatory conditions are assocaited with TMJ dysfunction and these screening tools can aid in the diagnosis.
Magnetic Resonance Imaging
This is used to assess the degree of soft tissue changes and inflammation within the TMJ. It is one of the first investigations indicated. A common finding is an inflammed and disrupted articular disc. In the image below, there is bony changes as well as a displaced disc.
An MRI slice of a patient with a painful clicky jaw joint
Computer Tomography Imaging(CT scanning)
For more definitive imaging of the bony anatomy, CT imaging is the gold standard. This can assess the degree of bone destruction and also is required for planning in total joint replacement.
This is a CT image of a patient with end stage TMJ degenerative disease after trauma. The jaw joints were fractured in an accident many years earlier and has led to the irregular images seen.