Radiology · patient case question
Which imaging modality best evaluates the bony condyles in this patient?
Patient case: Painful mandibular deviation on opening
Patient: Adult with temporomandibular symptoms
Chief complaint: Pain and restricted mouth opening.
Background: No relevant medical history reported.
Current findings: On opening, the mandible deviates to the RIGHT and remains deviated. Opening is limited and painful.
Show answer and explanation
Correct answer: A. Cone beam computed tomography
- A. CBCT provides three-dimensional, distortion-free imaging of the condylar bony morphology, and is the modality of choice for assessing erosion, flattening, osteophytes and degenerative change.
- B. A lateral cephalogram is used for skeletal and orthodontic analysis, not condylar detail.
- C. A panoramic view is a useful screening image but superimposes structures and distorts the condyle, so subtle bony change is readily missed.
- D. A periapical film cannot image the joint at all.
Note: Important qualification: CBCT images BONE. If the question concerns the DISC or other soft tissue, MRI is the modality of choice.