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Osteochondritis dissecans of the temporomandibular joint

¹ Department of Radiology, Faculdade de Odontologia, Universidade Federal da Bahia, Brasil; ² Department of Surgery, Curso de Odontologia da Escola Baiana de Medicina e Saúde Pública, Bahia, Brasil; ³ Department of Radiology, Faculdade de Odontologia de Piracicaba, Universidade de Campinas, São Paulo, Brasil; ⁴ Clínica Delfín – Diagnóstico por Imagem, Bahia, Brasil; ⁵ FAPESB (Fundação de Amparo à Pesquisa do Estado da Bahia, Research Support Foundation of the State of Bahia) scholarship holder

*Correspondence to: Prof. Dr. Paulo Sérgio Flores Campos, Rua Guadalajara, n° 841, ap. 201, Ondina, CEP: 40.140-460, Salvador, Bahia, Brasil; E-mail: pflores{at}superig.com.br

Received 26 April 2004; revised 5 January 2005; accepted 16 January 2005

A case is reported of a 43-year-old female patient presenting bilateral osteochondritis dissecans (OCD) of the temporomandibular joint (TMJ), in different stages for each side, associated with avascular necrosis (AVN) of the right condyle. Additionally observed was anterior disk displacement without reduction for both sides. We have proposed an adaptation of the previous classification of OCD for cases affecting the TMJ. We have also stressed the fundamental role of panoramic radiography on the diagnosis of stage 3 and stage 4 OCD of the TMJ. In relation to MRI, we have recommended sagittal (slice thickness of 2 mm) and coronal (slice thickness of 1 mm) fast spin-echo proton density-weighted sequences to better identify bone lesions (stage 1 and 2) and also localize osteochondral loose bodies; and coronal (slice thickness of 1 mm) fat-suppressed fast spin-echo T₂ weighted sequence to better evaluate OCD (stable or unstable) and the features of the occasionally associated AVN (acute or chronic).

Keywords: osteochondrosis dissecans; temporomandibular joint; magnetic resonance imaging; radiography, panoramic

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