Osteoarthritis of the temporomandibular joint

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 parts of the joint ⁵.