Synovial Enhancement of the Temporomandibular Joint on Magnetic Resonance Imaging in Healthy Children

PURPOSE:

To report the prevalence of synovial enhancement of the temporomandibular joint (TMJ) on magnetic resonance imaging (MRI) in healthy children

MATERIALS AND METHODS:

This was a retrospective study of children undergoing MRI at Children’s Healthcare of Atlanta. Patients were included if they obtained an MRI of the head for a non-autoimmune indication. Medical records and MRIs were reviewed to document demographic (age, gender) and MRI findings (glenoid margin synovial enhancement, condylar margin synovial enhancement, condyle enhancement, condyle morphology, condyle T1 signal, condylar erosions, condylar volume loss, effusion). The outcome variable was the presence or absence of TMJ findings on MRI. Descriptive and bivariate statistics were used to identify associations (significant at P ≤ .05).

RESULTS:

Eighty seven patients (54 males, 33 females) with a mean age of 11.2 years met the inclusion criteria. Of these, 70% had condylar enhancement, 64% of joints were found to have glenoid marginal synovial enhancement, 56% had condylar margin synovial enhancement and 19% of joints had condylar T1 signal. There were no joints with condylar erosion, condylar volume loss or effusion. Patients with condylar enhancement were found to be younger than patients without condylar enhancement (mean age 10.3 vs. 13.4, P<0.05). Condylar enhancement was more prevalent in males than in females (0.78 vs. 0.69, P<0.05). There was no difference in synovial enhancement between older and younger children or males and females.

CONCLUSION:

This preliminary study found a high prevalence of TMJ synovial enhancement in healthy children. Many asymptomatic children had radiographic findings associated with TMJ pathology. In a healthy child, MRI findings of TMJ synovial enhancement should be carefully correlated with clinical evaluation.