Neuromuscular – Other Diagnostics
There are a variety of common diagnostic modalities employed by health care practitioners to confirm or deny an initial diagnosis of TMJ which is based upon objective physical findings and subjective complaints. Some of these diagnostic modalities are more reliable than others. Radiography is the most common.
Conventional Radiography (plain x-rays, including Panorex) is quick, painless, and relatively inexpensive. However, since they only show just the bony structure of the joint, they are generally useful for ruling out obvious pathological changes and disease processes.
Presently the Cone Beam CT scan provides superb detail of bone in multiple directional planes, with a minimal dose of radiation. They are inexpensive and provide visualization of parts of your head and neck that are not visible on standard x-rays. The scan shows multiple 3D views of the bone in the jaw and face, roots of the teeth, TMJ joints and many other hard tisue structures necessary to plan your treatment.
Magnetic Resonance Imaging (MRI) produces brilliantly detailed and accurate images of bone as well as soft tissue, and is widely considered the best single way to study the TMJ. No radiation is used; however, since sophisticated equipment is needed, MRIs are expensive and can be cost prohibitive — sometimes over a $1,000 for both sides.
Arthrography allows the study of the position and function of the joint, including the disc. It involves the injection of contrast dye into the joint, followed by imaging using plain x-rays, tomograms, videotape, or a combination. A skilled examiner is a must, and the procedure can be very uncomfortable, but if done properly, Arthrography can be an extremely accurate diagnostic tool.