Evaluation of the temporomandibular joint by magnetic resonance imaging using a standardized evaluation form

For the past 15 years magnetic resonance imaging (MRI) has increasingly been used in the diagnosis of craniomandibular disorders. The present standardized evaluation form was created to establish a more systematic approach to the evaluation of MRI images of the temporomandibular joint. The initial parameters to be evaluated are condylar morphology (compacta and spongiosa), fossa and tubercular morphology, and disk morphology. Next, the condyle/fossa relationship with the mouth open and closed, the disk position in two planes (coronal, vertical to the long axis of the condyle) with the mouth open and closed, and the bilaminar zone are examined. Finally, the T2-weighted signals in the condylar region, in the joint space, and in the bilaminar zone are evaluated. The MRI images presented originate from a retrospective study of 77 patients in whom an arthropathy of the temporomandibular joint was clinically suspected. The images were taken using bilateral temporomandibular surface coils and FLASH or SE sequences (T1 and T2 weighting) in two planes without using a contrast medium. The standardized evaluation form streamlines MRI diagnosis. Moreover, the risk that subsidiary findings might be missed is minimized. Keywords: craniomandibular disorders, CMD, temporomandibular joint, diagnosis, magnetic resonance imaging, evaluation form