The one question that largely confuses TMJ Pain patients is
What kind of X-ray/imaging is needed to diagnose this disorder?
Is it an X-ray? Is it an MRI? What do they infer? So, let’s understand the basics of the diagnosis of TMJ Disorder and the role that imaging plays in it.
The first thing to understand here is that imaging and tests are not definitive for diagnosing a TMJ Disorder; rather, an experienced professional is the one who can diagnose it for you. What does that involve? A consultation with TMJ Specialist Dr. Shikha Goyal involves an extensive clinical examination, including muscle palpation, functional assessment of the jaw, biting pressure, and bite placement.
Now, imaging is an accessory that is used to understand the extent to which your TMJ disorder has progressed. X-ray-based imaging is primarily useful for assessing changes in the bony structures of the joint. But it does not help identify changes in the articular disc. The articular disc is the tissue present in the joint space. Soft tissues are better visualized in an MRI. Not every patient needs an MRI or an X-ray.
While the type of imaging required depends on what your clinician is looking for, here are the techniques more frequently used –
1. CBCT
A CBCT scan is an advanced form of a CT scan that helps visualise any advanced changes in the bone, joint, condyle, or other hard tissue structures. It is a 3D X-ray that shows the architecture of the bone around your Temporomandibular Joint. When the disease progresses to an extent where there are arthritic changes occurring in the bone, this imaging technique can help identify them. It can be particularly useful for assessing the shape and position of the condyle and identifying changes such as enlargement, flattening, erosion, or other bony alterations.
2. MRI
An MRI is a soft tissue scan that can be used to visualise the position and any changes in the articular disc that is present in the joint.
3. Airway Assessment
An airway assessment is useful in selected patients, particularly when there are concerns about breathing patterns, sleep-related issues, or other factors that may be relevant to their overall jaw function.
Ideally, the radiologist reading and reporting on TMJ scans must also have specialized training in the field of TMJ imaging, as it can be quite complex to interpret TMJ Scans.
At Dr. Goyal’s TMJ and Dental care, we regularly see patients who complain of severe jaw pain even though their regular dental X-rays seem to be ‘fine’. In such cases, a clinical assessment should come first, with imaging being prescribed when it is indicated. One thing to remember in terms of TMJ Disorder is that TMD is a clinical diagnosis, and imaging is only an aid to the diagnosis by a trained professional.