Radiographic and surgical evaluation of internal derangements of the temporomandibular joint.

A prospective study of 287 patients who underwent temporomandibular surgery for disc dysfunction was conducted. The patients were evaluated by combinations of polydirectional tomography, microfocus magnification, and arthrographic radiographic modalities. Abnormalities of the hard and soft tissue structures of the joints were determined radiographically and compared with the findings of surgical examination. Polydirectional tomography and microfocus magnification compared favorably with each other, as well as in their ability to show the actual abnormalities. Arthrography had a high degree of correlation with actual pathologic disc alterations, except for the 15% incidence of false-positive findings of perforation. The combination of either polydirectional tomography or microfocus magnification with arthrography is recommended for complete evaluation of the painful temporomandibular joint that shows evidence of limited range of motion.