Radiology of the Temperomandibular Joint
Patients with TMJ dysfunction give a constant history of pain. Many oral surgeons and otolaryngologists first order a radiograph known as a rotational panoramic radiograph or film. This is because of the low cost, easy availablity, and simplicity of obtaining this study. In fact, this study is recommended by the American Academy of Oral and Maxillofacial Radiology, the American Academy of Orofacial Pain, and the American Academy of Pediatric Dentistry.
However, there is much controversy about using this film study for a screening. The accuracy of the images
obtained has not been thoroughly investigated. This is because of poor patient positioning, distortion effects, and the difficulty in viewing the relative anatomic relationships of the joint.
Some oral surgeons recommend that if the diagnosis of TMJ dysfunction is supported clinically and the rotational panoramic study is non-diagnostic, the patient should have a magnetic resonance image (MRI) or computed tomography (CT) study of the TMJ.
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