Temporomandibular joint (axiolateral oblique view)

Changed by Andrew Murphy, 21 Mar 2017

Updates to Article Attributes

Title was changed:

~~Axiolateral temporomandibular~~Temporomandibular joint ~~(TMJ~~(axiolateral view)

Status changed from pending review to published (public).

Published At was set to .

Body was changed:

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The axiolateral ~~TMJ~~temporomandibular view allows for ~~good visualization~~visualisation of the articular tubercle, mandibular condyle and fossa and is thus useful to identify ~~bony~~structural changes and displaced fractures, as well as assess excursion and joint spaces.

Clinical indications include trauma, the presence of joint noises, trismus and occlusal alterations¹.

Patient Positionposition

~~Patient~~the patient is seated upright with the side of interest closest to the detector.
~~The~~the head is placed in a true lateral position
- ~~Inter~~inter-Pupillary Line (IPL) perpendicular and Mid-Sagittal Plane parallel to the detector
~~Oblique~~oblique the body to assist in patient positioning and reduce the object to image receptor distance
depending on the projection (open or closed mouth) instruct the patient to open their mouth side and keep it there or keep it shut

Technical factors

~~Left~~left and right lateral and open and closed mouth
~~Centering~~centering point
- ~~Central~~central ray 25º-30º caudad, ~~centered~~centred 5cm superior and 1 cm anterior to the EAM
~~Collimation~~collimation
- Nono more than ~~10x10cm~~10x10 cm with TMJ of interest is in the middle of the image
~~Orientation~~orientation
- ~~Portrait~~portrait
~~Detector~~detector size
- 18 cm X 24 cm
~~Exposure~~exposure
- 70-75 kVp
- 16-25 mAs
SID
- ~~≈ 100~~ 100 cm
~~Grid~~grid
- ~~Yes~~yes

Image technical evaluation

~~The~~the TMJ closest to the image receptor should be clearly demonstrated without the superimposition of the opposite TMJ.
~~Joint~~joint is ~~centered~~central on the radiograph

Practical Pointspoints

Aa radiolucent support such as a sponge can be used to help the head maintain position
~~Can~~this projection can be performed prone~~. This may~~, in patients that cannot stand unsupported this will increase patient stability

-The axiolateral TMJ view allows for good visualization of the articular tubercle, mandibular condyle and fossa thus useful to identify bony changes and displaced fractures, as well as assess excursion and joint spaces. Clinical indications include trauma, presence of joint noises, trismus and occlusal alterations 1.<h4>Patient Position</h4><ul>
~~-<li>Patient is seated upright with the side of interest closest to the detector.</li>~~
~~-<li>The head is placed in a true lateral position<ul><li>Inter-Pupillary Line (IPL) perpendicular and Mid-Sagittal Plane parallel to the detector</li></ul>~~
+The axiolateral temporomandibular view allows for visualisation of the articular tubercle, mandibular condyle and fossa and is thus useful to identify structural changes and displaced fractures, as well as assess excursion and joint spaces. Clinical indications include trauma, the presence of joint noises, trismus and occlusal alterations 1.<h4>Patient position</h4><ul>
+<li>the patient is seated upright with the side of interest closest to the detector.</li>
+<li>the head is placed in a true lateral position<ul><li>inter-Pupillary Line (IPL) perpendicular and Mid-Sagittal Plane parallel to the detector</li></ul>
~~-<li>Oblique the body to assist in patient positioning and reduce object to image receptor distance</li>~~
+<li>oblique the body to assist in patient positioning and reduce the object to image receptor distance</li>
+<li>depending on the projection (open or closed mouth) instruct the patient to open their mouth side and keep it there or keep it shut</li>
~~-<li>Left and right lateral and open and closed mouth</li>~~
+<li>left and right lateral and open and closed mouth</li>
~~-Centering point<ul><li>Central ray 25º-30º caudad, centered 5cm superior and 1 cm anterior to the EAM</li></ul>~~
+centering point<ul><li>central ray 25º-30º caudad, centred 5cm superior and 1 cm anterior to the EAM</li></ul>
~~-Collimation<ul><li>No more than 10x10cm with TMJ of interest is in the middle of the image</li></ul>~~
+collimation<ul><li>no more than 10x10 cm with TMJ of interest is in the middle of the image</li></ul>
~~-Orientation<ul><li>Portrait</li></ul>~~
+orientation<ul><li>portrait</li></ul>
~~-Detector size<ul><li>18 cm X 24 cm</li></ul>~~
+detector size<ul><li>18 cm X 24 cm</li></ul>
~~-Exposure<ul>~~
+exposure<ul>
~~-SID<ul><li> ≈ 100 cm</li></ul>~~
+SID<ul><li> 100 cm</li></ul>
~~-Grid<ul><li>Yes</li></ul>~~
+grid<ul><li>yes</li></ul>
~~-<li>The TMJ closest to the image receptor should be clearly demonstrated without the superimposition of the opposite TMJ.</li>~~
~~-<li>Joint is centered on the radiograph</li>~~
~~-</ul><h4>Practical Points</h4><ul>~~
~~-<li>A radiolucent support such as a sponge can be used to help the head maintain position</li>~~
~~-<li>Can be performed prone. This may increase patient stability</li>~~
~~-</ul> ~~
+<li>the TMJ closest to the image receptor should be clearly demonstrated without the superimposition of the opposite TMJ.</li>
+<li>joint is central on the radiograph</li>
+</ul><h4>Practical points</h4><ul>
+<li>a radiolucent support such as a sponge can be used to help the head maintain position</li>
+<li>this projection can be performed prone, in patients that cannot stand unsupported this will increase patient stability</li>
+</ul>

References changed:

1. Ferreira LA, Grossmann E, Januzzi E, Paula MVQd, Carvalho ACP. Diagnosis of temporomandibular joint disorders: indication of imaging exams. Brazilian Journal of Otorhinolaryngology. 2016;82:341-52.
Ferreira LA, Grossmann E, Januzzi E, Paula MVQd, Carvalho ACP. Diagnosis of temporomandibular joint disorders: indication of imaging exams. Brazilian Journal of Otorhinolaryngology. 2016;82:341-52.

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