Casi clinici

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Casi clinici

• Risonanze magnetiche

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Dynamic MRI sequence of a TMJ of a 25-year old
patient with an anterior disc displacement with
reduction. The clicking occurred in the late
stage of mouth opening. Notice how the disc is
pushed past the eminence, where it bends into a U
shape. Then the disc-condyle relationship is
reduced while the bent disc returns to its normal
shape.
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2
Dynamic MRI sequence of a TMJ of a 22-year-old
female patient with an anterior disc displacement
without reduction. During opening the mobile disc
is pushed ventrally by the condyle.
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3
Dynamic MRI sequence of an opening/closing
movement of a normal TMJ of a 38-year-old male
subject. The harmonious movements between condyle
and disc are clearly visible. Notice also some
bending of the disc at the end of the opening.
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Dynamic MRI sequence of the TMJ of a 50-year-old
male patient with a chief complaint of
crepitation. The static images of this patient
show clearly the irregular bony surfaces of both
the condyle and the eminence. An area of low
signal cranially and dorsally to the condyle is
visible. During condylar movement this structure
moves ventrally together with the condyle. Notice
also the area of high signal (joint fluid)
ventrally and cranially to the condyle.
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Dynamic MRI sequence of a TMJ of a 20-year-old
male patient with an anterior disc displacement
without reduction. During opening the ventral
part of the disc hardly moves, while the dorsal
part tends to bend by moving ventrally. The
sequence suggests that the disc is stuck.
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Dynamic MRI sequence of a 19-year-old female
patient with an anterior disc displacement with
reduction. The disc is located under the
eminence. Notice how during the initial opening
the disc bends caudally to a U shape. Suddenly,
the disc springs dorsally to a reduced position.
At the end of closing the disc is again in its
initial position under the eminence.
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Dynamic MRI sequence of a TMJ of a 24-year-old
female patient with an anterior disc displacement
with reduction. Notice that the patient needs 3
movement phases to fully open the mouth. In the
first phase there is some translation, followed
by a rotary movement and dorsal translation. The
disc is not reduced. In the second phase the disc
is reduced. The sequence stops with the condyle
under the eminence. Finally, the condyle
translates and rotates ventrally to the eminence.

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Dynamic MRI sequence of a 19-year old female
patient with an anterior disc displacement with
and without reduction, ie, with occasional
locking. The sequence demonstrates the full
opening path with disc reduction (first cycle)
and without reduction (second cycle). In the
sequence without reduction, the disc is pushed
ventrally and caudally without bending.