Temporomandibular joint inflammation

Last revised by Tom Foster on 6 Apr 2022

Temporomandibular joint (TMJ) inflammation may occur as a result of an inflammatory arthropathy or secondary to TMJ dysfunction. Since the TMJ is a synovial joint, it is susceptible to inflammatory arthropathies that affect other joints. 

It is important to realize that active periods of TMJ dysfunction may also produce inflammatory signs.

Radiographic features

Imaging of choice is MRI, which unfortunately is unable to distinguish between them, as all share the same spectrum of imaging findings.

  • synovitis and pannus formation (distinguished from TMJ effusion by administration of contrast)
  • soft tissue swelling and edema (best seen on STIR): this is most pronounced in the retrodiscal zone
  • bone marrow edema
  • effusion
  • marginal erosions
  • joint space narrowing

Complications

Eventually, secondary degenerative osteoarthritic changes develop (see TMJ OA), with joint space narrowing, cortical erosions, condylar flattening, and marginal osteophytes

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