Magnetic resonance imaging findings of the retrodiskal tissue in TMJ internal derangement

Cho, Bong Hae

Abstract

PURPOSE
To describe the MRI findings of the retrodiskal tissue in patients presenting with TMJ internal derangement and to correlate these findings with clinical and other MRI manifestations. MATERIALS AND METHODS: One hundred eighteen joints of 63 patients with TMJ internal derangement were examined by MRI. T1-weighted sagittal MR images taken in both closed- and open-mouth were evaluated for the presence of demarcation between disk and retrodiskal tissue, the presence of low signal intensity, and the depiction of the temporal part of the posterior attachment. The results were correlated with the duration of TMJ internal derangement, the presence of pain, and other MRI findings, including the type of internal derangement, the extent of disk displacement, the degree of disc deformation, and the presence of osteoarthrosis. RESULTS: A significant relationship between the presence of low signal intensity in the retrodiskal tissue and other MRI findings was determined. Low signal intensity on the open-mouth view was observed more frequently in patients with disc displacement without reduction, severe disc displacement and deformation, and osteoarthrosis (p< 0.05). The demarcation between disk and retrodiskal tissue, and the depiction of the temporal part of the posterior attachment (TPA) were correlated neither with clinical, nor with other MRI findings. CONCLUSION: This study suggests that low signal intensity in the retrodiskal tissue on open-mouth MR image can be indicative of advanced stages of disk displacement.