Revision 2 for 'Temporomandibular joint (axiolateral view)'

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Axiolateral temporomandibular joint (TMJ)

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.

Patient Position

  • Patient is seated upright with the side of interest closest to the detector.
  • The head is placed in a true lateral position
    • Inter-Pupillary Line (IPL) perpendicular and Mid-Sagittal Plane parallel to the detector
  • Oblique the body to assist in patient positioning and reduce object to image receptor distance

Technical factors

  • Left and right lateral and open and closed mouth
  • Centering point
    • Central ray 25º-30º caudad, centered 5cm superior and 1 cm anterior to the EAM
  • Collimation
    • No more than 10x10cm with TMJ of interest is in the middle of the image
  • Orientation
    • Portrait
  • Detector size
    • 18 cm X 24 cm
  • Exposure
    • 70-75 kVp
    • 16-25 mAs
  • SID
    •  ≈ 100 cm
  • Grid
    • Yes

Image technical evaluation

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

Practical Points

  • A radiolucent support such as a sponge can be used to help the head maintain position
  • Can be performed prone.  This may increase patient stability

 

 

 

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