Presentation
Patient complaining of popping in the left TMJ. The right TMJ was asymptomatic. No reports of pain, swelling, or limited function in any of the TMJs.
Patient Data
CT images demonstrate an apparent cortical discontinuity in the roof of the right mandibular fossa, spanned a width of approximately 4,0 mm anteroposterior. Images obtained with the mouth closed show the mandible's condyle in its usual position centred on the mandibular fossa; When the mouth is open, the condyle moves anteriorly under the centre of the articular eminence. There is earwax (cerumen) within the right external auditory canal. Peripheral mucosal thickening and mucous retention cysts/polyps in both maxillary sinus.
Impression: These findings are compatible with an apparent discontinuity of the roof of the right mandibular fossa.
MR images confirm a small area of an apparent cortical discontinuity in the roof of the right mandibular fossa with fluid density but no soft tissue abnormalities, masses, or signs of meningoencephalocele in the TMJs or adjacent regions. The disks are normal concerning their shape and position.
Impression: These findings are consistent with an apparent discontinuity of the roof of the right mandibular fossa.
Case Discussion
The thickness of the roof of the mandibular fossa is variable, and it may be a skinny bone, simulating osseous discontinuity 1-3. This case demonstrates an apparent discontinuity of the roof of the right mandibular fossa, with such TMJ being asymptomatic.
Case courtesy
Gustavo Cavalcanti de Petribu F. Rocha, MD - radiologist
Antonio Rodrigues de Aguiar Neto, MD - radiologist
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