Aggarwal S, Mukhopadhyay S, Berry M, Bhargava S
Department of Radio-Diagnosis, All India Institute of Medical Sciences, New Delhi.
Oral Surg Oral Med Oral Pathol. 1990 Jan;69(1):128-32. doi: 10.1016/0030-4220(90)90281-v.
Bony ankylosis of the temporomandibular joint is a disabling disease that almost invariably manifests itself in the first two decades of life. CT of the temporomandibular joints was performed in 50 patients--axial CT in 2 and coronal CT in 48--of whom 43 (86%) had received trauma to the joints. New bone of variable form and thickness was observed in 64 joints (the involvement was bilateral in 14 patients). These joints were classified into one of two categories: type I, medially angulated condyle with deformed articular fossa and a mild-to-moderate amount of new bone formation; and type II, no recognizable condyle or fossa but instead a large mass of new bone. Type I was etiology-specific and seen only when trauma was the antecedent, whereas type II was a sequelae of either insult. A pseudofracture in the new bone was seen in 49 (77%) joints. Six joints showed subtle deformities but no new bone. Since coronal CT fully characterizes the lesion at acceptable radiation exposure levels, it appears to be valuable in the preoperative workup of these patients.
颞下颌关节骨性强直是一种致残性疾病，几乎总是在生命的前二十年出现症状。对50例患者进行了颞下颌关节CT检查——2例进行了轴向CT检查，48例进行了冠状CT检查——其中43例（86%）关节受过外伤。在64个关节中观察到了形态和厚度各异的新骨（14例患者为双侧受累）。这些关节被分为两类：I型，髁突向内侧成角，关节窝变形，有轻度至中度的新骨形成；II型，无法辨认髁突或关节窝，取而代之的是大量新骨。I型与病因相关，仅在有外伤史时出现，而II型是任何损伤的后遗症。49个（77%）关节的新骨中可见假骨折。6个关节有轻微畸形但无新骨。由于冠状CT在可接受的辐射剂量水平下能全面显示病变特征，因此在这些患者的术前检查中似乎很有价值。
