OBJECTIVES: To characterize the relationship between radiographic and clinical characteristics of patients with temporomandibular joint (TMJ) osseous changes. MATERIALS AND METHODS: TMJ cone beam computed tomography (CBCT) images of 73 patients (142 joints) with changes in osseous component of TMJ were included in this study. Based on both clinical and radiographic findings, each TMJ was diagnosed as either non-degenerative joint disease (non-DJD) or degenerative joint disease (DJD) according to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) criteria. The DJD group was further classified into two subgroups of osteoarthritis and osteoarthrosis. The data were analyzed using t test and Pearson's correlation. Level of statistical significance was set at 0.05. RESULTS: Statistically significant relationships were found between TMJ crepitation sound and 4 radiographic characteristics of DJD. DJD group demonstrated statistically significant higher CBCT bone change score (BCS) and age. In contrast, there was no significant difference of BCS between osteoarthrosis and osteoarthritis groups within the DJD group. CONCLUSIONS: Crepitation sounds and osseous changes in TMJ radiograph are confirmed to be important diagnostic criteria for TMJ DJD. However, degree of TMJ osseous changes does not correlate significantly with clinical pain symptom. CLINICAL RELEVANCE: For TMJ DJD diagnosis, dentists should consider both clinical examination for TMJ crepitation and radiographic assessment for TMJ bony changes.