Radiology, Vol 154, 121-124, Copyright © 1985 by Radiological Society of North America
Temporomandibular joint clicking with nonreducing anterior displacement of the meniscus
TL Miller, RW Katzberg, RH Tallents, RW Bessette and K Hayakawa
Patients who have temporomandibular joint (TMJ) clicking and pain are
assumed to have an anterior displacement of the meniscus with reduction on
opening of the jaw. On the basis of this assumption, these patients are
treated nonsurgically with splint therapy. Of 301 TMJs examined, 108 (36%)
produced clinically audible clicks on opening, closing, or both.
Fluoroscopy and arthrotomography studies for 16 (15%) showed anteriorly
displaced menisci without reduction. The mean age of this group was 32
years, with a range of 17-51 years. The duration of the patients' symptoms
ranged from three months to eight years (mean 3.7 years). Bilateral
degenerative joint disease was noted in 8/16 (50%). Operative findings in
four patients suggested the cause of the clicking sound as a frictional
impact between the degenerated surface of the condyle and the hypertrophied
displaced meniscus. These observations demonstrate that an audible click
may not imply a reduction of a displaced meniscus.
