Temporomandibular joint osteochondritis dissecans: case report.
BACKGROUND
Osteochondritis dissecans is a process in which segment(s) of cartilage separate from an articular surface. It is most often reported in the larger joints of the body, including the knee, elbow, hip, wrist, and ankle. Involvement of the temporomandibular joint (TMJ) is exceedingly rare.


OBJECTIVE
To describe a probable case of osteochondritis dissecans and discuss the differential diagnosis for this condition.


METHODS
In addition to clinical examination the patient was imaged using panoramic radiography, computed tomography and magnetic resonance imaging.


RESULTS
Panoramic radiography showed separation of 2 rounded fragments superior to the right mandibular condyle. These were more precisely located using 3-dimensional computerized tomographic reconstructions. Magnetic resonance imaging demonstrated the right condyle as having low signal intensity area on T1-weighted images and a heterogeneous signal on T2-weighted images, with low signal dominance. No abnormality was apparent in the left TMJ.


CONCLUSIONS
The patient was treated nonsurgically with a splint, occlusal adjustment, physiotherapy, and nonsteroidal antiinflammatory medications. Maximum mouth opening has increased from 24 mm to 39 mm 6 months following initiation of treatment, and pain has subsided.
Orhan
Kaan
K
Department of Oral Diagnosis and Radiology, Faculty of Dentistry, Ankara University, Ankara, Turkey. call53@yahoo.com
Arslan
Ahmet
A
Kocyigit
Doruk
D
D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007594:Joint Loose Bodies / Q000000981:diagnostic imaging; D008279:Magnetic Resonance Imaging; D008335:Mandibular Condyle / Q000000981:diagnostic imaging / Q000473:pathology; D019558:Occlusal Adjustment; D017090:Occlusal Splints; D010008:Osteochondritis Dissecans / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy; D011862:Radiography, Panoramic; D016059:Range of Motion, Articular; D013704:Temporomandibular Joint / Q000000981:diagnostic imaging / Q000473:pathology; D013705:Temporomandibular Joint Disorders / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy; D014057:Tomography, X-Ray Computed
D000894:Anti-Inflammatory Agents, Non-Steroidal