Pediatric Radiology

, Volume 40, Issue 12, pp 1964–1965 | Cite as

Temporomandibular joint injections: interventional MR imaging demonstrates anatomical landmark approach to be inaccurate when compared to direct visualization of the injectant

  • Jan FritzEmail author
  • Philippe L. Pereira
  • Jonathan S. Lewin
Letter to the Editor


We read with interest the article from Dr. Parra and colleagues [1] published online 2010 March 4.

The authors are to be congratulated on their efforts in the development of an imaging guidance technique with the intention to reduce the use of ionizing radiation in children [2]. However, the authors’ routine use of CT of the temporomandibular joints following needle placement exposes children to ionizing radiation and makes their technique less desirable than US alone or interventional MRI.

Not least for this fact, the authors discuss interventional MRI as a co-existing technique for temporomandibular joint injections in children. We were, however, surprised about the omission of the citation reporting the technique of real-time MRI guidance for intra-articular injections of the temporomandibular joints resulting in an overall technical accuracy of 100%. We, therefore, wish to provide this necessary reference to the readers of Pediatric Radiology [3].

Dr. Parra and colleagues...


Needle Placement Needle Guidance Technical Accuracy Imaging Guidance Technique Imaging Verification 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Supplementary material


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  1. 1.
    Parra DA, Chan M, Krishnamurthy G et al (2010) Use and accuracy of US guidance for image-guided injections of the temporomandibular joints in children with arthritis. Pediatr Radiol 40:1498–1504CrossRefPubMedGoogle Scholar
  2. 2.
    Connolly B, Racadio J, Towbin R (2006) Practice of ALARA in the pediatric interventional suite. Pediatr Radiol 36(Suppl 2):163–167CrossRefPubMedGoogle Scholar
  3. 3.
    Fritz J, Thomas C, Tzaribachev N et al (2009) MRI-guided injection procedures of the temporomandibular joints in children and adults: technique, accuracy, and safety. AJR 193:1148–1154CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • Jan Fritz
    • 1
    Email author
  • Philippe L. Pereira
    • 2
  • Jonathan S. Lewin
    • 1
  1. 1.Russell H. Morgan Department of Radiology and Radiological ScienceJohns Hopkins University School of MedicineBaltimoreUSA
  2. 2.Department of Radiology, Minimally Invasive Therapies and Nuclear MedicineSLK-Kliniken HeilbronnHeilbronnGermany

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