Osteoarthritis of the temporomandibular joint

Last revised by Joshua Kogan on 4 Nov 2024

Osteoarthritis of the temporomandibular joint (TMJ) is the end point of long-standing TMJ dysfunction. It is a common finding incidentally on a base of skull imaging, and it should be remembered that TMJ pain does not correlate well with osteoarthritic changes. Indeed pain from TMJ dysfunction is often self-limiting.

Radiographic features 

Changes are usually more evident on the condylar side of the joint:

  • flattening: common (in one series 27%)

  • osteophytes: common (27%)

  • erosions: 13%

  • sclerosis: less common (9%)

  • subchondral cysts

Treatment and prognosis

Symptomatic treatment usually involves the intra-articular injection of hyaluronic acid, corticosteroids, diclofenac, or glucosamine 4. Injection can be preceded by arthrocentesis (joint lavage). Definitive treatment consists of prosthetic replacement of the joint articular surface 5.

Cases and figures

  • Case 1
  • Case 2: left sided OA
  • Case 3
  • Case 4: severe OA
  • Case 5: sclerosis - closed
  • Case 6: hypertrophy and flattening
  • Case 7: large osteophytes
  • Case 8: on SPECT-CT
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