J Korean Radiol Soc.  1989 Feb;25(1):93-98. 10.3348/jkrs.1989.25.1.93.

Disc perforations of the temporomandibular joint: pitfalls in the arthrographic diagnosis

• Choi HS
• Lee KS
• Kim WS
• Sung JH
• Jun YH

• KMID: 2383156
• DOI: http://doi.org/10.3348/jkrs.1989.25.1.93

Abstract

Temporomandibular joint(TMJ) arthrography is a highly accurate diagnostic modality for the internalderangement of TMJ including disc perforation. Tears or perforations of the disc are easily recognized whensimultaneous filling phenomenon of the upper joint space (UJS) occurs with injection of contrast material into thelower joint space(LJS). But the reported incidence of false positive cases of perforation in about 15-20%. So,authors analyzed 34 patients with TMJ dysfunction and 5 volunteers and evaluated disc perforation and itspitfalls. The following results noted: 1. We got 5 true positive and 2 false positive cases of disc perforation,and 1 experimental case could show the possible genesis of the pseudo-perforation phenomenon. 2. Very importantdiagnostic points of disc perforation were the visible perforation site, the absence of penetration of the lateralrecess of UJS during the puncture of LJS, and accompanying severe bony and disc degenerative changes. 3. Technically, to minimize the incidence of artificial perforation, the mouth motion and excessive contrast fillingshould be avoided during injection of LJS.

MeSH Terms

Arthrography
Diagnosis*
Humans
Incidence
Joints
Mouth
Punctures
Tears
Temporomandibular Joint*
Volunteers