Internal derangement of the temporomandibular joint: an audit of clinical findings, arthrography and surgical treatment.

Forty seven patients who underwent double contrast video-arthrography followed by surgery for internal derangement of the temporomandibular joint were reviewed retrospectively. Of the 50 joints assessed, arthrography demonstrated 39 (78%) with irreducible meniscal displacement and 11 (22%) with reducible displacement. Clinical findings were found to be unreliable in demonstrating the degree of internal derangement: 49% of irreducible meniscal displacements presented with clicking and only 20% with loss of click. The importance of video-arthrography is emphasised. Surgery for internal derangement proved successful. It is proposed that patients who have clinical evidence suggestive of irreducible meniscal displacement and have disabling symptoms should undergo early video-arthrography and be offered surgical correction.