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Objectives: The aim of this study was to investigate bone changes in the condyle, articular eminence and glenoid fossa in relation to the position of the articular disc. Methods: 148 temporomandibular joints (TMJs) of 74 symptomatic patients who underwent MRI were evaluated. The position of the disc was classified as either normal (N), disc displacement with reduction (DDwR), disc displacement without reduction (DDwoR) and posterior displacement (PD). Bone changes were investigated in the condyle and temporal components of the TMJ and classified as osteophytosis, sclerosis or erosion. Results: There were no bone changes in the glenoid fossa of the temporal bone. Of the total number of TMJs studied, 94 (63.5%) were N, 34 (23%) presented DDwoR, 19 (12.8%) presented DDwR and 1 (0.7%) presented PD. The bone changes in the condyle and posterior aspect of the articular eminence were associated with the position of the disc. The bone changes in the anterior aspect of the articular eminence were not associated with the position of the disc. Conclusion: In cases of DDwoR, bone changes in the condyles were more common. The combination of erosion and osteophytosis in the condyle and the bone changes of the posterior aspect of the articular eminence were associated with disc position.

A rare case of aplasia of the mandibular condyle is presented along with the tomographic findings. A 31-year-old Caucasian woman presented with a main complaint of facial asymmetry. No family history or any trauma was found. A CT study was performed and the sagittal CT view demonstrated a complete absence of the left condyle. This case of unknown aetiology was thoroughly examined and, based on clinical findings, we suggest that it could be of developmental origin.

The aim of the present study was to investigate the relationship between degenerative bone changes of the head of the mandible and the presence of joint effusion (JE). This study was based on sagittal magnetic resonance imaging (MRI) reports of 148 temporomandibular joints (TMJs) of 74 patients complaining of pain and/or dysfunction in the TMJ area. The mandible heads were surveyed for osteoarthritis characteristics, which were classified as osteophytosis, sclerosis or erosion. The presence of JE was checked whenever high signal intensity was observed in the articular space. The results evidenced the presence of bone changes in 30% of the sample. Osteophytes and erosions were the changes most commonly observed. JE was reported in 10% of TMJs. The results from the statistical tests revealed that bone changes in the head of the mandible are associated with the presence of JE.

The aim of the present study was to investigate the relationship between degenerative bone changes of the head of the mandible and the presence of joint effusion (JE). This study was based on sagittal magnetic resonance imaging (MRI) reports of 148 temporomandibular joints (TMJs) of 74 patients complaining of pain and/or dysfunction in the TMJ area. The mandible heads were surveyed for osteoarthritis characteristics, which were classified as osteophytosis, sclerosis or erosion. The presence of JE was checked whenever high signal intensity was observed in the articular space. The results evidenced the presence of bone changes in 30% of the sample. Osteophytes and erosions were the changes most commonly observed. JE was reported in 10% of TMJs. The results from the statistical tests revealed that bone changes in the head of the mandible are associated with the presence of JE.

Purpose: Juvenile idiopathic arthritis (JIA) has unknown etiology, and the involvement of the temporomandibular joint (TMJ) is rare in the early phase of the disease. The present article describes the use of computed tomography (CT) and magnetic resonance (MRI) images for the diagnosis of affected TMJ in JIA.Case description: A 12-year-old, female, Caucasian patient, with systemic rheumathoid arthritis and involvement of multiple joints was referred to the Imaging Center for TMJ assessment. The patient reported TMJ pain and limited opening of the mouth. The helical CT examination of the TMJ region showed asymmetric mandibular condyles, erosion of the right condyle and osteophyte-like formation. The MRI examination showed erosion of the right mandibular condyle, osteophytes, displacement without reduction and disruption of the articular disc.Conclusion: The disorders of the TMJ as a consequence of JIA must be carefully assessed by modern imaging methods such as CT and MRI. CT is very useful for the evaluation of discrete bone changes, which are not identified by conventional radiographs in the early phase of JIA. MRI allows the evaluation of soft tissues, the identification of acute articular inflammation and the differentiation between pannus and synovial hypertrophy.Key words: Juvenile idiopathic arthritis; temporomandibular joint; computed tomography; magnetic resonance imaging ResumoObjetivo: A artrite idiopática juvenil (AIJ) tem etiologia desconhecida e o envolvimento da articulação temporomandibular (ATM) é raro no estágio inicial da doença. Este artigo descreve o uso de imagens de tomografia computadorizada (TC) e de ressonância magnética (RM) para o diagnóstico de ATM afetada pela AIJ.Descrição do caso: Uma paciente de 12 anos de idade, leucoderma, portadora de AIJ com envolvimento de múltiplas articulações foi encaminhada ao Centro de Imaginologia para avaliação das ATMs. A paciente relatou dor na ATM e limitação de abertura bucal. O exame com TC helicoidal da região da ATM com reconstruções a 1 mm mostrou assimetria entre os côndilos mandibulares, erosão do côndilo direito e formação osteofítica. O exame de RM mostrou erosão do côndilo mandibular direito, osteófito, deslocamento sem redução e ruptura do disco articular.Conclusão: As desordens de ATM devido à AIJ devem ser cuidadosamente examinadas por modernas técnicas de imagem. A TC é muito útil para a detecção e avaliação de estruturas ósseas da ATM e permite o exame de alterações ósseas discretas, que não seriam identificadas por radiografias convencionais nas fases iniciais de AIJ. A RM permite a avaliação de tecidos moles, identificação de inflamação articular aguda e diferenciação entre hipertrofia sinovial e do pannus. Palavras

Objective To determine the frequency of radiographic changes in the temporomandibular joint, in a representative population of patients with Juvenile Idiopathic Arthritis (JIA) and to compare with findings in healthy controls matched by sex and age. Patients and Methods One hundred and thirty-seven panoramic radiographies (PR) from JIA patients of a pediatric rheumatology outpatient clinic were prospectively evaluated and compared to 137 PR from healthy individuals. Results 102 (74.5%) JIA patients and 47 (34.3%) controls showed at least one radiological alteration (p < 0.001). The following radiographic alterations were more frequently observed in JIA patients than in controls: erosion (p < 0.001), altered condylar morphology (p < 0.001), disproportion between condylar process and the coronoid process (p < 0.001) and accentuated curve in the antegonial notch (p = 0.002). Twenty patients (14.6%) presented the four radiographic alterations simultaneously compared to only two controls (1.5%) (p < 0.001). Conclusion Due to the difference in the frequency of findings in the PR of patients and controls, we concluded that PR has value as a screening tool. In the presence of major changes in the mandible head in the PR of patients with a confirmed diagnosis of JIA, MRI should be considered to detect an active inflammatory process in this joint.

| The lateral pterygoid muscle (LPM) has been the focus of numerous studies attempting to elucidate its possible role in temporomandibular disorders (TMDs). Disc displacement is widely accepted as a fi nding characteristic of this clinical condition. However, few studies have investigated the association between disc position and morphological alterations of the LPM. Objectives: to investigate the relationship between articular disc position and area measurements of the superior head (SH) and inferior head (IH) of the LPM using magnetic resonance (MR) imaging. Methods: The sample comprised 148 temporomandibular joints (TMJs) of 74 patients with complaints of pain and/or dysfunction in the TMJ area. Sagittal plane images were used for assessments of disc position and for tracings. Tracings of the areas of the heads were performed under 4 mandibular positions (at rest, and openings of 10 mm, 20 mm, and 30 mm) with the aid of image processing software. Data acquired was subjected to statistical analysis. Results: Statistical tests revealed changes in LPM head areas during mandibular opening movement, showing a reduction in total IH area and more heterogeneous changes in SH area. Relevance: The IH mean area was reduced in the positions assessed and showed no correlation with disc displacement. For the SH, reduced mean area was associated with anterior disc displacements without reduction, while increased mean areas were correlated with anterior disc displacement with reduction.descrIPtors | Magnetic Resonance Imaging; Temporomandibular Joint; Pterygoid Muscles. resuMo | Avaliação por ressonância magnética da alteração dimensional do músculo pterigóideo e da posição do disco articular no movimento mandibular • O músculo pterigóideo lateral (MPL) tem sido o foco de inúmeros estudos que tentam elucidar o seu possível papel na disfunção temporomandibular, condição na qual o deslocamento do disco é amplamente aceito como um possível aspecto clínico. No entanto, poucos estudos investigaram a associação entre a posição do disco e alterações morfológicas do MPL. Objetivos: investigar a relação entre a posição do disco articular e a área da porção superior e da porção inferior da músculo pterigóideo lateral usando ressonância magnética. Métodos: A amostra foi composta por 148 articulações temporomandibulares de 74 pacientes com queixa de dor e/ou disfunção articular. Imagens em plano sagital foram utilizadas para a avaliação da posição do disco e para traçados. Traçados das áreas do músculo foram realizados em 4 posições mandibulares (em repouso, e em aberturas de 10 mm, 20 mm e 30 mm) com a ajuda de software de processamento de imagem. Os dados adquiridos foram submetidos à análise estatística. Resultados: Os testes estatísticos revelaram mudanças nas áreas superior e inferior do músculo pterigóideo lateral durante o movimento de abertura mandibular, mostrando uma redução na área total e mudanças mais heterogêneos na área superior. Relevância: Observou-se que a área média da porção inferior muscular estava reduzida...