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Referral details

Case 44974

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Referral category

Temporomandibular joints (TMJ)

Region of interest

TMJ

Referral reason

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2 Files Info

Canaray 44974

1. Cystic lesion in left condylar head: possible simple bone cyst

A unilocular radiolucent entity with a thinly corticated periphery and scalloping borders is present along the medial pole of the left condylar head. This entity has thinned and slightly expanded the cortices of the condyle, but these cortices appear intact.

These radiographic features are suggestive of a simple bone cyst. Periodic radiographic follow up is recommended to substantiate the diagnosis. The possibility of a small aneurysmal bone cyst cannot be ruled out. Imaging such as MRI may be recommended to make this distinction.

Axial views of left condylar head

These axial cross-sectional images demonstrate thinning and slight expansion of the cortical plates overlying the medial aspect of the left condylar head.

2. Possible subchondral cyst at the medial pole of left TMJ

Subchondral cysts or other small, simple bone cysts are present at the superior surface of the medial pole of the left condylar head overlying the larger cystic lesion. This may be a sign of early degenerative joint disease in the left temporomandibular joint.

Coronal views of left condylar head

These coronal cross sectional images demonstrate a cystic lesion has formed at the medial aspect of the left condylar head. The scalloping border of the lesion is also evident in these images.

Sagittal views of left condylar head

These sagittal cross sectional images demonstrate the normal appearance of the lateral aspect of the left condylar head. No degenerative changes are visible in the articular component of the joint.

Posteriorly positioned left condylar head in mandibular closed position

In the mandibular closed position, the left condylar head is posteriorly positioned in the glenoid fossa. This may infer the possibility of a soft tissue derangement, such as an anteriorly displaced disc or secondary to the mild expansion of the medial pole of the condylar head associated with the cystic lesion. No signs of osseous degeneration are present on the articular surfaces of the glenoid fossa and the lateral pole of the condylar head.

Posteriorly positioned right condylar head in mandibular closed position

In the mandibular closed position, the right condylar head is slightly posteriorly positioned in the glenoid fossa. This may reflect the presence of a soft tissue derangement such as an anteriorly displaced disc, or represent a normal anatomic variant in the condylar head position. No signs of degeneration are present.

Normal translation of condyles in mandibular open position

In the mandibular open position, both condylar heads are positioned at the crests of the articular eminences. This is normal. This suggests that if anteriorly displaced discs are present, they reduce upon opening.

Unerupted tooth 18

The unerupted tooth 18 is developing normally. The follicle surrounding the crown of the tooth appears normal. This tooth has not had any effect upon the surrounding structures.

Partially erupted tooth 28

Tooth 28 is vertically oriented and partially erupted in the left posterior maxillary alveolar process. The crown of tooth 28 is positioned distal to the cementoenamel junction of tooth 27. Tooth 28 has not caused damage to the distal surface of tooth 27.

Mesioangularly impacted tooth 38

Tooth 38 is mesioangularly impacted. The left mandibular canal passes buccal to the developing root apices of tooth 38 and is not compressed. The follicle surrounding the crown of tooth 38 appears normal and no damage has occurred to the distal surface of tooth 37.

Horizontally impacted tooth 48

Tooth 48 is horizontally impacted. The follicle surrounding the crown of the tooth has a normal overall appearance. No damage has occurred to the distal surface of tooth 47. The right mandibular nerve canal passes buccally to the developing root apices of tooth 48. No nerve compression is present.

3. Calcified stylohyoid ligaments

The stylohyoid ligaments are partially calcified bilaterally. This is an incidental finding with no clinical significance.