Temporomandibular joint: correlation between single-contrast videoarthrography and postmortem morphology

Arthrography of the temporomandibular joint is widely performed in clinical practice. The diagnostic accuracy of this technique has not been systematically evaluated. Therefore, findings from transcranial single-contrast, lower-compartment videoarthrography of 58 temporomandibular joint autopsy specimens were correlated with postmortem morphology. Arthrographic diagnosis of disk position and perforation was confirmed in 47 joints (81%). Misinterpretations were made in 11 joints; nine concerned disk position and two concerned perforation. Analysis of the misinterpretations revealed that inability of arthrography to allow differentiation of lateral from medial resulted in four false-negative diagnoses and one false-positive diagnosis. Variation of joint anatomy with disk deformation resulted in four false-positive diagnoses of anterior disk position. The number of false diagnoses in clinical practice might be reduced if transcranial single-contrast, lower-compartment videoarthrography is followed by multilayer arthrotomography in cases with an unclear diagnosis.