The use of bone scintigraphy in temporomandibular joint disorders

INTRODUCTION: The use of bone scintigraphy (bone scan) in the diagnosis of temporomandibular joint (TMJ) disease has been infrequent, as compared with traditional radiographic techniques. Bone scans have the potential to detect active bone remodeling whereas corresponding radiographs may be normal or document past structural change in the joint. Traditional radiographic findings and relevant clinical signs and symptoms correlated with bone scans may aid in the diagnosis of TMJ disease and possibly affect treatment and prognosis of individual cases. The use of bone scans as an additional tool in diagnosing TMJ disease was assessed in this series of patients. METHODS: Thirty consecutive subjects with TMJ tenderness were selected for bone scintigraphy using technetium diphosphonate 99 mTc and single photon emission computerized tomography. These subjects received bone scans as well as other selected imaging modalities for diagnostic purposes. RESULTS AND DISCUSSION: The findings on bone scan were evaluated and a change in preliminary clinical diagnosis or treatment was made in 60% of cases because of the findings on bone scintigraphy. Bone scintigraphy may be valuable to assess progress of TMJ inflammation or remodeling, and may affect diagnosis and treatment of patients with TMJ tenderness.