Radiographic Evaluation Medical Assignment Help

Radiographic Evaluation

Radiographs of the TMJ are extremely helpful in the diagnosis Of lntraarticular, osseous, and soft tissue pathology. The use of radiographs in the evaluation of the patient with TMD should be based on the patient’s sigs and symptoms instead of routinely ordering a “standard” set of radiographs. In many cases the panoramic radiograph provides adequate information as a screening radiograph in  evaluation of TMD. A variety of other radiographic techniquesare available that may provide useful information
in certain cases.  ranscranial radiographs. A standard dental radiogtaphlc
unit combined with a head-holding device can be used to produce a transcranlal image of the TMJ. Although this view will not allow detailed examination of all aspects of the TMJ, excellentevaluation of the lateral
pole of the condyle can be accomplished when the proper radiographic technique. is used. Because bony pathology of the TMJ frequently extends to the lateral pole, this technique can be helpful in diagnosing bony
internal joint pathology (Fig. 30-4).1 . Panoramic radiograph)”. One of the best overall radiographs for screening evaluation of the TMJs is the
panoramic radiograph. This technique allows visualization  both TMJs on the same film. Because a panoramic technique provides a tomographic type of view of the TM], this can frequently provide a good assessment of the
bony anatomy of the articulating surfaces of the mandibular condyle and glenoid fossa (Fig. 30-5), and other areas, such as the coronoid process, can also be visualized. Many machines are equipped to provide special views of the mandible, focusing prlmarily on the area of the TMJs. These radiographs can often be completed in both the open and closed position
Totnograms. The tomographic technique allows more detailed view of the TMP This technique allows.radiographic sectioning of the joint at different levels of the condyle and fossa complex, which provides individual
views visualizing the joint in “slices” from the medial to  the lateral pole “(Fig. 30-6). These views eliminate. bonysuperimposition and overlap and provide a relatively clear picture of the bony anatomy of the joint (see Fig. 30-6).

riG. 3G-: Systematic evaluation of muscles of mastication. · A, Palpation of masseter muscle. B, Palpation of temporalis muscle. C, Palpation of medial pterygoid intraorally. 0, Palpation of origin of lateral pterygoid. E, Palpation of sternocleidomastoid muscle.

riG. 3G-: Systematic evaluation of muscles of mastication.
· A, Palpation of masseter muscle. B, Palpation of
temporalis muscle. C, Palpation of medial pterygoid intraorally.
0, Palpation of origin of lateral pterygoid. E, Palpation
of sternocleidomastoid muscle.

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imaging method was the. first technique available that allowed visualization (indirect) of the intraarticular’ disk. Arthrography involves. the injection of contrast material into the inferior or superior spaces of a [oint, after
Which the joint is radiographed.’ Evaluation of the configuration of the dye in the joint spaces allows evaluation of the position and morphology of the articular disk (Fig. 30-7). This technique also demonstrates the presence of
perforations and adhesions of the disk or its attachments. With the availability of more advanced, less invasive techniques arthrography is rarely used. Computed tomography. Computed tomography (CT)
provides a combination of tomographic views of the joint, combined with computer enhancement of hard and soft tissue images.” This technique allows evaluation of a variety of hard and soft tissue pathology in the joint. CT images provide the most accurate radiographic assessment of the bony components of the joint (Fig. 3Q-8}. CT scan reconstruction capabilities allow images obtained in one plane of space to be reconstructed so that the images  be evaluated from a different view. Thus evaluation  of the joint from a variety of perspectives can be madefrom a slngleradiation exposure The most efectiv eiagnostic imaging technique to evaluate TMJ soft tissues is magnetic resonance imaging (MRI) (Fig. 30-9).5 This
technique al ows excellent images of- intraarticular soft tissue, making MRI a valuable technique for evaluating disk morphology and position. MRI images -can be obtained showing dynamic joint function in ‘a cinematic
fashion, providing. valuable information about the anatomical components of the joint during function. The’ fact that this technique does not use ionizing radiation is a significant advantage. Ylle/eol’ imrlgillg. This technique involves injection’ of Tc99, a gamma-emitting isotope that is concentrated in areas of active bone metabolism. Approximately 3 hours
after injection of the isotope, images are obtained using a gamma camera. Single photon emission computerized ~ tomography (SPECT) images can then be used to determine active areas of bone metabolism (Fig. 39-10).6″

 

 

 

 

 

 

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