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robbypowell's version from 2016-07-25 15:52

tmj area imaging

Question Answer
T/F: Pan angle is selected to match the long axis of the articular head of the condyleTrue
which is better at detecting mild changes in bone... pan or CBCT?CBCT
what type tissue is an MRI used to to evaluate?soft tissue
T/F: we don't use and MRI for tmj imaging unless we have a patient whose symptoms persist even after therapyT
T/F: if a patient presents with TMJ pain, the first imaging technique to use is MRIFalse
Degenerative Joint Disease represents ___% of patients examined for TMJ pain10%
T/F: Condyles vary greatly in shapeTrue
T/F: Condyles should be rounded unless shape is changed by disease processFalse (vary greatly in shape)
Complete calcification of cortical borders of the condyle and gleaned fossa may not complete until ____ years old20
Erosion indicates (acute/chronic) diseaseAcute
T/F: Erosion with sclerotic borders indicates healingTrue
T/F: Erosion with sclerotic borders indicates aggressive processFalse
T/F: Erosion without sclerotic borders indicates healingFalse
T/F: Erosion without sclerotic borders indicates aggressive processTrue
T/F: you can see erosion on a panFalse (erosion is an alteration of surface of condyle... can't detect on pan... need CBCT)
Flat eminence and condyle with opacitySubchondral Sclerosis (increased density and thickness of the cortical bone layer)
Flattening of the _____ surface can be indicative of Degenerative Joint Disease of the TMJAnterior (one it translates on)
normal joint spaces ___mm anterior, ___mm superior, ___mm posterior1.5mm; 2.5 mm; 1.5 mm
T/F: pan is a reliable method to judge the relationship of condyle and fossaFalse
markedly Inferior condylar positioning is indicative of ____ _____synovial chondromatosis
most common disease process that affects the TMJRheumatoid Arthritis
Bone erosions, osteophytes, and loss of joint space are signs of _____Osteoarthritis aka DJD
term meaning Increased thickness and density of the cortical bone layerSubchondral Sclerosis (aka Eburnation)
Morphological changes of the articular condyle can create boney outgrowths called ______Osteophytes (this is beak of bird's beak)
t/f: markedly eccentric condylar positioning usually represents an abnormalityTrue
t/f: mild or moderate condylar eccentricity usually represents an abnormalityFalse (diagnostic significance "unclear" Condylar eccentricity is seen 1/3 to ½ of asymptomatic individuals)
t/F: erosion of the condyles is a hallmark of rheumatoid arthritisTrue
Granulomatous involvement of the synovial membranes that spreads to the articular surfaces describes what pathology of the TMJ?Rheumatoid Arthritis
pathological changes of the TMJ in patients with rheumatoid arthritis usually present ____-laterallyBI-laterally (both sides)
Rheumatoid arthritis is more common in which gender?Females
What % of patients with RA show TMJ involvement?50%
T/F: Degenerative Joint disease is usually asymptomatic, but if symptoms are present they are Unilateral pain, Stiffness, Crepitus, Limited opening and DeviationTrue
term for area of degeneration that occurs just below the joint surface and it is very round and well-definedEly's Cyst
T/F: Ely's cyst has an epithelial liningFalse (not a true cyst, but an area of degeneration that is well defined)
T/F: Ely's cyst has no epithelial liningTrue (not a true cyst, but an area of degeneration that is well defined)
Radiographic signs of inhibited mandibular growth include deepening of _____ notchantegonial notch
Radiographic signs of inhibited mandibular growth include diminished height of _____ramus
Radiographic signs of inhibited mandibular growth include _____ bending of the ramus and condylar neckDorsal
T/F: In Still's disease evident in the TMJ, Unilateral onset is common but bilateral involvement can occur as disease progressesTrue
T/F: Idiopathic Condylar Resorption will result in an open bite and generally presents with bilateral and symmetrical involvementTrue
T/F: Still's disease evident in the TMJ will result in an open bite and generally presents with bilateral and symmetrical involvementFalse (this describes Idiopathic Condylar Resorption... Stills Disease aka JRA has unilateral onset but sometimes can become bilateral... not symmetrical)
Congenital Condylar _______ is associated with Treacher Collins and Hemifacial microsomia (Goldenhar syndrome)Hypoplasia
Condylar Hypoplasia is more common in what gender?Males
Cessation of growth of condyle (Condylar Hypoplasia) may be assessed with what type of scans?nuclear medicine technetium bone scans
Coronoid process enlargement is more common in what gender?Males
radiopacities of varying origin located in the synovium, within the joint space, or outside the joint space in soft tissue are called _____ ______Loose bodies
Two types of malignancy that can cause loose bodies in the TMJChondrosarcoma & Osteosarcoma
T/F: Osteochondritis dissecans is always symptomaticFalse (may or may not be symptomatic)
3 most common benign tumors of the TMJChondroma, osteochondroma, and osteoma
How common are Benign and malignant tumors originating in or involving the TMJRare
Malignancies such as osteosarcoma and chondrosarcoma appear (radiopaque/radiolucent) in the TMJ?Radiopaque
Why might you see signs of radiopacity on condylar fracture due to trauma?Overlapping portions of bone
trauma most likely causes fracture where in the mandible?Condylar neck
memorize

Which pathologic condition?

Question Answer
Flattening of condyles, Erosions, Cyst formations, reduced mobility... Severe Resorption WITHOUT remodelingRheumatoid Artheritis (Psoriatic arthritis and Ankylosing spondylitis may look similar)
Granulomatous involvement of the synovial membranes that spreads to the articular surfaces describes what pathology of the TMJ?Rheumatoid Arthritis
this condition is Characterized by joint deterioration and proliferation and CAN be seen unilaterally and is more common in joints with long-term non-reducing disksDegenerative Joint Disease (DJD) aka Osteoarthritis
Etiology of this condition is unknown although acute trauma, hypermobility, and parafunction may play a roleDJD (Degenerative Joint disease aka Osteoarthritis)
Bony growth in joints is a hallmark of this conditionOsteoarthritis (aka DJD)
Non-sclerosive erosion of the condyle is a hallmark of this conditionRheumatoid Arthritis (maybe also Psoriartic Arthritis and Ankylosing spondylitis???)
flattening, subchondral sclerosis, and cortical thickening are radiographic signs that can effect the condyle and articular eminence in this conditionOsteoarthritis (DJD)
Bone erosions, osteophytes, and loss of joint space are signs of ______DJD (Osteoarthritis)
Micrognathia (due to interference with condylar growth) is associated with which arthritic condition that can present with TMJ pathology?Juvenile Rheumatoid Arthritis (Still's disease)
Micrognathia, Anterior open bite, Limited opening, Eventual ankylosis that can present unilaterally are associated with what condition?Juvenile Rheumatoid Arthritis (Still's disease)
Distinctive radiographic appearance of no condyles, associated with what systemic condition ?Still's Disease (Juvenile Rheumatoid Arthritis)
Distincitve radiographic appearance of no condyles that happens in females in the second decade of life (can happen 10-40.. but strong predilection for teenagers) without other systemic condition (believed to be caused by hormonal mitigated synovial tissue proliferation)Idiopathic Condylar Resorption
Condition that is more common in young males... usually unilaterally, and has a tendency to create posterior open bite on unaffected sideCondylar Hypoplasia
Condition that is more common in young males and should be considered when limitation of opening cannot be explained by intra-articular disturbancesCoronoid process enlargement
Condition that presents in women 30-50 yo with Symmetric PDL widening, resorption of mandibular angle, condyle, coronoid process, and fingers... and Deposition of Calcific material in tissue adjacent to jawsScleroderma (Progressive systemic sclerosis)
Metabolic/Metastatic cause of loose bodies in the TMJRenal disease
accumulation of crystals of calcium pyrophosphate dihydrate in the connective tissuesChondrocalcinosis
more common in females, hallmark sign is joint space widening unilaterally ... radiopacities may or may not be present in the joint spaceSynovial Chondromatosis
Metaplasia of synovium with formation of foci of hyaline cartilage.. presents with no osseous changes ...Synovial Chondromatosis
Detachment of bone fragments or cartilage, Corresponding bony defect is seen radiographically (more than half are due to trauma)Osteochondritis dissecans
memorize

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