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Research ArticleArticles

MR of Osteochondritis Dissecans and Avascular Necrosis of the Mandibular Condyle

Kurt P. Schellhas, Clyde H. Wilkes, Hollis M. Fritts, Mark R. Omlie and Lawrence B. Lagrotteria
American Journal of Neuroradiology January 1989, 10 (1) 3-12;
Kurt P. Schellhas
1 Center for Diagnostic Imaging, 5775 Wayzata Blvd., Suite 190, St. Louis Park, MN 55455. Address reprint requests to K. P. Schellhas.
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Clyde H. Wilkes
2 Park Place Center, 5775 Wayzata Blvd., Suite 990, St. Louis Park, MN 55416.
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Hollis M. Fritts
1 Center for Diagnostic Imaging, 5775 Wayzata Blvd., Suite 190, St. Louis Park, MN 55455. Address reprint requests to K. P. Schellhas.
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Mark R. Omlie
3 250 Central Ave. N., Wayzata, MN 55391.
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Lawrence B. Lagrotteria
4 801 N. Plaza Dr., Suite 106, Schaumberg, MN 55455.
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Abstract

We studied 40 patients exhibiting radiologic changes of either osteochondritis dissecans (OCD) or avascular necrosis (AVN) involving the mandibular condyle to evaluate the structural changes associated with these lesions when using high-field-strength MR imaging. Various clinical indications for imaging each patient with routine radiography, tomography, and surface-coil MR included headache, temporomandibular joint (TMJ) and/or ilsilateral facial pain, joint crepitus, clicking, locking, and either recently acquired or changing (unstable) occlusal disorder. Radiologic findings included alterations in condyle morphology and MR signal characteristics compatible with either OCD or AVN or, in some cases, both. Previous nonsurgical mandibular trauma was temporally related to the onset of symptoms in eight patients. Five patients exhibiting either unilateral or bilateral AVN involving the condyles and condylar necks had undergone previous orthognathic surgery, including sagittal split mandibular osteotomies followed by intermaxillary fixation. One patient exhibiting condylar AVN with articular surface collapse and osseous destruction had undergone previous TMJ meniscectomy followed by insertion of a permanent Proplast implant. Thirty-one of 34 patients with no prior surgery and MR changes of condylar OCD/AVN had associated internal derangement of the TMJ meniscus. There was surgical confirmation of findings in 10 joints.

We assert that OCD and AVN are relatively common, clinically significant lesions of the mandibular condyle often associated with preexisting internal derangement of the temporomandibular joint.

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American Journal of Neuroradiology
Vol. 10, Issue 1
1 Jan 1989
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MR of Osteochondritis Dissecans and Avascular Necrosis of the Mandibular Condyle
Kurt P. Schellhas, Clyde H. Wilkes, Hollis M. Fritts, Mark R. Omlie, Lawrence B. Lagrotteria
American Journal of Neuroradiology Jan 1989, 10 (1) 3-12;

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MR of Osteochondritis Dissecans and Avascular Necrosis of the Mandibular Condyle
Kurt P. Schellhas, Clyde H. Wilkes, Hollis M. Fritts, Mark R. Omlie, Lawrence B. Lagrotteria
American Journal of Neuroradiology Jan 1989, 10 (1) 3-12;
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