Direct sagittal computed tomography of the temporomandibular joint.

Temporomandibular joint dysfunction is a common c linical problem that has been reported to affect 4%-28% of adu lts [1, 2). The characteristic signs and symptoms are joint pain, tenderness, joint noises, and limitation of opening [3 , 4). Temporomandibular joint arthrography has shown that many of these patients have intraarticular abnurmalities involving the meniscus [1 , 5-8] (Katzenberg RW, Keith DA , Guralnick WC, Manzione JV, Ten Eick WR, unpublished data) . An anteriorly displaced meniscus is believed to be the cause of the signs and symptoms in many [5-7). Disadvantages of arthrography are that it is invasive and at times painful. A noninvasive test that cou ld demonstrate the meniscus as well as bony abnormalities of the joint would be an important advance. In an attempt to develop such a noninvasive test, we have performed direct sagittal computed tomography (CT) on cadaver temporomandibular joints and have correlated the images with anatomic sections (Manzione JV, Seltzer SE, Katzberg RW, Hammerschlag S8, unpublished data). We are currently applying this technique clinically and report one representative example in which direct sagittal computed tomography of the temporomandibular joint accurately demonstrated an anteriorly displaced meniscus.