Schellhas K P
Center for Diagnostic Imaging, St Louis Park, MN 55416.
Radiology. 1989 Oct;173(1):211-6. doi: 10.1148/radiology.173.1.2781010.
The clinical and radiologic findings in 30 patients who sustained injuries to the temporomandibular joint (TMJ) were retrospectively analyzed. Imaging consisted of variable combinations of radiography, tomography, two-compartment arthrography, computed tomography, and magnetic resonance imaging and was performed 2 days to 24 months after injury. Indications for imaging included acquired and/or unstable occlusal disturbances, cephalalgia, facial pain, otalgia, TMJ pain, tinnitus, dizziness, hearing disturbance, masticatory dysfunction, and muscle atrophy. Radiologic findings included internal derangement of the TMJ meniscus, swelling of retrodiskal tissues, joint effusion, mandibular condyle and condylar neck fractures, osteochondritis dissecans, avascular necrosis, degenerative condylar remodeling, osteoarthritis, musculotendinous injuries, and atrophy of masticatory muscles. After imaging studies, seven patients underwent surgery, at which time imaging findings were confirmed; one patient underwent successful aspiration of a painful hemarthrosis. TMJ injuries may result in joint derangement, radiologically demonstrable joint degeneration, masticatory muscle dysfunction, pain, and progressive clinical disability.
对30例颞下颌关节（TMJ）损伤患者的临床和影像学检查结果进行了回顾性分析。影像学检查包括X线摄影、体层摄影、双腔关节造影、计算机断层扫描和磁共振成像等多种组合，在受伤后2天至24个月进行。影像学检查的指征包括后天性和/或不稳定的咬合紊乱、头痛、面部疼痛、耳痛、颞下颌关节疼痛、耳鸣、头晕、听力障碍、咀嚼功能障碍和肌肉萎缩。影像学检查结果包括颞下颌关节半月板内紊乱、盘后组织肿胀、关节积液、下颌髁突和髁突颈部骨折、剥脱性骨软骨炎、缺血性坏死、髁突退行性重塑、骨关节炎、肌腱损伤和咀嚼肌萎缩。在影像学检查后，7例患者接受了手术，术中证实了影像学检查结果；1例患者成功抽吸了疼痛性关节积血。颞下颌关节损伤可能导致关节紊乱、影像学上可显示的关节退变、咀嚼肌功能障碍、疼痛和进行性临床残疾。
