MRI OF THE TEMPOROMANDIBULAR-JOINT DISK AND POSTERIOR DISK ATTACHMENTBEFORE AND AFTER NONSURGICAL TREATMENT

Purpose: Our goal was to investigate the role of serial dynamic contra st-enhanced SPGR MRI in the nonsurgical follow-up of patients with tem poromandibular joint (TMJ) pain. Method: Ten patients (10 joints) with internal derangement of the TMJ were imaged with T1-weighted SE and s erial postgadolinium SPGR MR pulse sequences. Results: On TI-weighted images prior to treatment, the disk position was normal in one joint a nd anteriorly displaced without reduction in nine joints. After treatm ent, the disk remained normally positioned in one joint, was anteriorl y displaced without reduction in eight joints, and was anteriorly disp laced with reduction in one joint. The dynamic study after treatment s howed a decrease in contrast enhancement of the posterior disk attachm ent in 7 of 10 joints. These seven patients had resolution or reductio n in joint pain. Conclusion: These results suggest an association betw een a decrease in contrast enhancement of the posterior disk attachmen t and resolution or reduction in joint pain. This association was much stronger than the association between the clinical findings and the a natomy of the disk.