TMJ

[Linh]

Hi Steve,

How are you?

I got a referral for a 11 year old for a TMTJ US ?synovitis. What is your scanning technique and protocol? What do you look for with the dynamic aspect of the scan? Do you get them to chew/protract/retract their jaw?

Bets regards,
Linh

[Stephen Bird]

Hi Linh,

I keep these pretty simple.

I scan in the long axis of the TMJ in the long length of the mandibular condyle.

The TMJ looks a bit like a baby version of a long axis hip joint image.

The joint capsule passes along the condyle and attaches in a similar way to the anterior hip joint.

Compare both sides.

Like the hip joint when you see a concave joint capsule relative to the underlying bone it is pathological.

You may see an effusion or synovial proliferation.

I then ask them to open and close the mouth slowly and observe the range of movement and compare with the other side.

You can also use ultrasound to inject the joint with steroid.

There are some old published papers on looking for disk tears with ultrasound, but I have never had any luck with this !

Steve

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