29-year-old female with TMJ pain and clicking, evaluate TMJ for arthritic changes and disk derangement. History of bilateral mandibular condyle fractures. Right temporomandibular joint: There is anterior dislocation of the TMJ disc with no recapture on the open-mouth sequences. The disc itself demonstrates normal low signal intensity on all sequences. The mandibular condyle is centered on the glenoid fossa, however the head of the mandibular condyle demonstrates contour irregularity and spur formation protruding into the joint space. On the open-mouth sequences the mandibular condyle remains centered over the glenoid fossa.Left temporomandibular joint: There is anterior dislocation of the TMJ disc with no recapture on the open-mouth sequences. The disc itself demonstrates normal low signal intensity on all sequences. The mandibular condyle is centered on the glenoid fossa, however the head of the mandibular condyle demonstrates contour irregularity and spur formation protruding into the joint space. On the open-mouth sequences the mandibular condyle remains centered over the glenoid fossa. The previously noted mandibular condyle fracture is partially visualized and better evaluated on recent CT study.
1. Bilateral TMJ disc dislocation with no recapture. 2. The mandibular condyles remain centered over the glenoid fossa on the closed and open sequences. In addition there are osteoarthritic changes affecting the mandibular condyles with spur formation protruding into the expected region of the temporomandibular joints.