COMPARISON OF ARTHROTOMOGRAPHIC AND MAGNETIC-RESONANCE IMAGES OF 50 TEMPOROMANDIBULAR JOINTS WITH OPERATIVE FINDINGS

Arthrotomography and magnetic resonance imaging (MRI) were carried out on 50 temporomandibular joints (TMJs) in 48 patients who were being c onsidered for surgery for clinically diagnosed internal derangement. T he patients presented over a 4-year period with pain and dysfunction w hich had failed to respond to conservative management. Open surgery wa s carried out on all TMJs and operative findings compared with the res ults of imaging. The clinical diagnosis of internal derangement was co nfirmed in every case by imaging and at surgery. Arthrotomography over -diagnosed non-reducibility of an anteriorly displaced meniscus and pe rforation. MRI over-diagnosed non-reducibility to a lesser extent and under-diagnosed perforation. MRI demonstrated neither bony changes nor adhesions. Dynamic arthrotomography produced the best images of menis cal derangement in function and the pre-arthrogram tomograms were the best indicator of osseous abnormality. Arthrotomography was the prefer red imaging technique.