Osteoarthritis of the temporomandibular joint

Last revised by Dr Henry Knipe on 15 Jun 2018

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.

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Cases and figures

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