Disc perforation is an advanced form of the internal derangement of the TMJ. Perforation may results from the extensive deformation or deterioration caused by the macrotrauma and microtrauma. We used both methods, arthrogram and MRI, and combined
the
imaginary data for the correct diagnosis of the disc perforation. Sometimes these findings were helpful to decide the surgical procedures and to find out the site of perforation.
We experienced some cases of TMJ disc perforation, and tried to find out the specific signs on arthrogram and MRI supporting the nature or site of perforation.
1. Arthrogram was superior in the diagnosis of the TMJ disc perforation itself.
2. Morphologic changes, disc displacements and suspectable signs of disc perforation were more clearly observed in MRI.
3. MR findings such as severe disc displacement, disc deformation(shortened, folded, or separated disc), retrodiscal thinning, joint space narrowing and bony erosion on the eminence and condyle head may be the signs of disc perforation.
4. In the clinical point of view, long history of trauma, crepitus and long-standing joint pain may suggest TMJ disc perforation.
5. For the accurate diagnosis and proper treatment planning, the use of both arthrogram and MRI is needed.
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