• Kaan Orhan
  • Ingrid Różyło-Kalinowska


Ultrasonography (US) is performed using physical properties of ultrasound, i.e. acoustic waves propagated within a patient’s body with frequency above 20,000 Hz. Feasibility of an ultrasound unit depends on the available probes. In diagnostics of TMJ, high-frequency linear probes (preferably over 12 MHz) with a relatively small “footprint” are used as they offer high resolution of image with a relatively low penetration depth which is sufficient in examinations of these superficially located joints. Intraoral probes are useful in imaging of masticatory muscles. As far as TMJ is concerned, the following applications were described: joint effusion, internal derangement and disc displacement; osteoarthrosis including condylar erosion; rheumatoid, psoriatic and juvenile idiopathic arthritis with TMJ involvement as well as polyarthritis; joint function basing on condylar translation range; condylar movement using Duplex Doppler; intrauterine TMJ dislocation; and interventional procedures such as guidance in fine needle aspiration cytology (FNAC), guidance for TMJ arthrocentesis and steroid injections. There are neither contraindications for ultrasound scanning nor special patient preparation required.


Ultrasound Temporomandibular joint Internal derangement 



The authors would like to thank to Associate Prof. Dr. Nilsun Bagis, Dr. Poyzan Bozkurt, Dr. Dilek Yılmaz, Dr. Katarzyna Portka and Dr. Leszek Szalewski for their contributions to the chapter.


  1. 1.
    Stagnitti A, Marini A, Impara L, Drudi FM, Lo Mele L, Odoardi GL. Duplex Doppler ultrasound study of the temporomandibular joint. J Ultrasound. 2012;15(2):111–4.CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Yuan S, Magarik M, Lex AM, Fleischer AC. Clinical applications of sonoelastography. Expert Rev Med Devices. 2016;13(12):1107–17.CrossRefPubMedGoogle Scholar
  3. 3.
    Katzberg RW. Is ultrasonography of the temporomandibular joint ready for prime time? Is there a “window” of opportunity? J Oral Maxillofac Surg. 2012;70(6):1310–4.CrossRefPubMedGoogle Scholar
  4. 4.
    Whaites E, Drage N. Essentials of dental radiography and radiology. 5th ed. London: Churchill Livingstone; 2013.Google Scholar
  5. 5.
    Kundu H, Basavaraj P, Kote S, Singla A, Singh S. Assessment of TMJ disorders using ultrasonography as a diagnostic tool: a review. J Clin Diagn Res. 2013;7(12):3116–20.PubMedPubMedCentralGoogle Scholar
  6. 6.
    Landes CA, Goral W, Mack MG, Sader R. 3-D sonography for diagnosis of osteoarthrosis and disk degeneration of the temporomandibular joint, compared with MRI. Ultrasound Med Biol. 2006;32(5):627–32.CrossRefPubMedGoogle Scholar
  7. 7.
    Landes CA, Goral WA, Sader R, Mack MG. Three-dimensional versus two-dimensional sonography of the temporomandibular joint in comparison to MRI. Eur J Radiol. 2007;61(2):235–44.CrossRefPubMedGoogle Scholar
  8. 8.
    Ahuja A, Evans R. Practical head and neck ultrasound. Cambridge: Cambridge University Press; 2013.Google Scholar
  9. 9.
    Manfredini D, Guarda-Nardini L. Ultrasonography of the temporomandibular joint: a literature review. Int J Oral Maxillofac Surg. 2009;38(12):1229–36. Scholar
  10. 10.
    Manfredini D, Tognini F, Melchiorre D, Zampa V, Bosco M. Ultrasound assessment of increased capsular width as a predictor of temporomandibular joint effusions. Dentomaxillofac Radiol. 2003;32:359–64.CrossRefPubMedGoogle Scholar
  11. 11.
    Weiss PF, Arabshani B, Johnson A, Bilaniuk LT, Zarnow D, Cahill AM, Feudtner C, Cron RQ. High prevalence of temporomandibular joint arthritis at disease onset in children with juvenile idiopathic arthritis, as detected by magnetic resonance imaging but not by ultrasound. Arthritis Rheum. 2008;58(4):1189–96. Scholar
  12. 12.
    Melis M, Secci S, Ceneviz C. Use of US for diagnosis of temporomandibular joint disorders: a review. Am J Dent. 2007;20:73–8.PubMedGoogle Scholar
  13. 13.
    Dong XY, He S, Zhu L, Dong TY, Pan SS, Tang LJ, Zhu ZF. The diagnostic value of high-resolution ultrasonography for the detection of anterior disc displacement of the temporomandibular joint: a meta-analysis employing the HSROC statistical model. Int J Oral Maxillofac Surg. 2015;44:852–8.CrossRefPubMedGoogle Scholar
  14. 14.
    Bas B, Yılmaz N, Gökce E, Akan H. Ultrasound assessment of increased capsular width in temporomandibular joint internal derangements: relationship with joint pain and magnetic resonance grading of joint effusion. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2011;112(1):112–7.CrossRefPubMedGoogle Scholar
  15. 15.
    Tognini F, Manfredini D, Mechiorre D, Zampa V, Bosco M. Ultrasonographic vs magnetic resonance imaging findings of temporomandibular joint effusion. Minerva Stomatol. 2003;52:365–72.PubMedGoogle Scholar
  16. 16.
    Uysal S, Kansu H, Akhan O, Kansu O. Comparison of ultrasonography with magnetic resonance imaging in the diagnosis of temporomandibular joint internal derangements: a preliminary investigation. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2002;94(1):115–21.CrossRefPubMedGoogle Scholar
  17. 17.
    Brandlmaier I, Rudisch A, Bodner G, Bertram S, Emshoff R. Temporomandibular joint internal derangement: detection with 12.5 MHz ultrasonography. J Oral Rehabil. 2003;30(8):796–801.CrossRefPubMedGoogle Scholar
  18. 18.
    Emshoff R, Bertram S, Rudisch A, Gassner R. The diagnostic value of ultrasonography to determine the temporomandibular joint disc position. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1997;84:688–96.CrossRefPubMedGoogle Scholar
  19. 19.
    Emshoff R, Jank S, Bertram S, Rudisch A, Bodner G. Disk displacement of the temporomandibular joint: sonography versus MR imaging. AJR Am J Roentgenol. 2002;178(6):1557–62.CrossRefPubMedGoogle Scholar
  20. 20.
    Emshoff R, Jank S, Rudisch A, Walch C, Bodner G. Error patterns and observer variations in the high-resolution ultrasonography imaging evaluation of the disk position of the temporomandibular joint. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2002;93(3):369–75.CrossRefPubMedGoogle Scholar
  21. 21.
    Kaya K, Dulgeroğlu D, Unsal Daelialioğlu S, Babadağ M, Tacal T, Barlak A. Diagnostic value of ultrasonography in the evaluation of the temporomandibular joint anterior disk displacement. J Cranio-Maxillofac Surg. 2010;38:391–5.CrossRefGoogle Scholar
  22. 22.
    Tognini F, Manfredini D, Mechiorre D, Bosco M. Comparison of ultrasonography and magnetic resonance imaging in the evaluation of the temporomandibular joint disc displacement. J Oral Rehabil. 2005;32:248–53.CrossRefPubMedGoogle Scholar
  23. 23.
    Li C, Su N, Yang X, Sh Z, Li L. Ultrasonography for detection of disc displacement of temporomandibular joint: a systematic review and meta-analysis. J Oral Maxillofac Surg. 2012;70(6):1300–9.CrossRefPubMedGoogle Scholar
  24. 24.
    Emshoff R, Brandlmaier I, Bodner G, Rudisch A. Condylar erosion and disc displacement: detection with high-resolution ultrasonography. J Oral Maxillofac Surg. 2003;61(8):877–81.CrossRefPubMedGoogle Scholar
  25. 25.
    Rudisch A, Emshoff R, Maurer H, Kovacs P, Bodner G. Pathologic-sonographic correlation in temporomandibular joint pathology. Eur Radiol. 2006;16(8):1750–6.CrossRefPubMedGoogle Scholar
  26. 26.
    Assaf AT, Kahl-Nieke B, Feddersen J, Habermann CR. Is high-resolution ultrasonography suitable for the detection of temporomandibular joint involvement in children with juvenile idiopathic arthritis? Dentomaxillofac Radiol. 2013;42(3):20110379.CrossRefPubMedPubMedCentralGoogle Scholar
  27. 27.
    Hechler BL, Phero JA, Van Mater H, Matthews NS. Ultrasound versus magnetic resonance imaging of the temporomandibular joint in juvenile idiopathic arthritis: a systematic review. Int J Oral Maxillofac Surg. 2018;47(1):83–9.CrossRefPubMedGoogle Scholar
  28. 28.
    Jank S, Zangerl A, Kloss FR, Laimer K, Missmann M, Schroeder D, Mur E. High resolution ultrasound investigation of the temporomandibular joint in patients with chronic polyarthritis. Int J Oral Maxillofac Surg. 2011;40(1):45–9.CrossRefPubMedGoogle Scholar
  29. 29.
    Melchiorre D, Calderazzi A, Maddali Bongi S, Cristofani R, Bazzichi L, Eligi C, Maresca M, Ciompi M. A comparison of ultrasonography and magnetic resonance imaging in the evaluation of temporomandibular joint involvement in rheumatoid arthritis and psoriatic arthritis. Rheumatology. 2003;42:673–6.CrossRefPubMedGoogle Scholar
  30. 30.
    Hayashi D, Roemer FW, Katur A, Felson DT, Yang SO, Alomran F, Guermazi A. Imaging of synovitis in osteoarthritis: current status and outlook. Semin Arthritis Rheum. 2011;41(2):116–30.CrossRefPubMedGoogle Scholar
  31. 31.
    Katzberg RW, Conway WF, Ackerman SJ, Gonzales TS, Kheyfits V, Cronan MS. Pilot study to show the feasibility of high-resolution sagittal ultrasound imaging of the temporomandibular joint. J Oral Maxillofac Surg. 2017;75(6):1151–62.CrossRefPubMedGoogle Scholar
  32. 32.
    Cakir-Ozkan N, Sarikaya B, Erkorkmaz U, Aktürk Y. Ultrasonographic evaluation of disc displacement of the temporomandibular joint compared with magnetic resonance imaging. J Oral Maxillofac Surg. 2010;68(5):1075–80.CrossRefPubMedGoogle Scholar
  33. 33.
    Gateno J, Miloro M, Hendler BH, Horrow M. The use of ultrasound to determine the position of the mandibular condyle. J Oral Maxillofac Surg. 1993;51:1081–6.CrossRefPubMedGoogle Scholar
  34. 34.
    Jank S, Emshoff R, Norer B, Missmann M, Nicasi A, Strobl H, Gassner R, Rudisch A, Bodner G. Diagnostic quality of dynamic high-resolution ultrasonography of the TMJ—a pilot study. Int J Oral Maxillofac Surg. 2005;34(2):132–7.CrossRefPubMedGoogle Scholar
  35. 35.
    Jank S, Rudisch A, Bodner G, Brandlmaier I, Gerhard S, Emshoff R. High-resolution ultrasonography of the TMJ: helpful diagnostic approach for patients with TMJ disorders? J Craniomaxillofac Surg. 2001;29(6):366–71.CrossRefPubMedGoogle Scholar
  36. 36.
    Landes CA, Sader R. Sonographic evaluation of the ranges of condylar translation and of temporomandibular joint space as well as first comparison with symptomatic joints. J Craniomaxillofac Surg. 2007;35:374–81.CrossRefPubMedGoogle Scholar
  37. 37.
    Landes CA, Walendzik H, Klein C. Sonography of the temporomandibular joint from 60 examinations and comparison with MRI and axiography. J Craniomaxillofac Surg. 2000;28(6):352–61.CrossRefPubMedGoogle Scholar
  38. 38.
    Çil AS, Bozkurt M, Bozkurt DK. Intrauterine temporomandibular joint dislocation: prenatal sonographic evaluation. Clin Med Res. 2014;12(1–2):58–60.CrossRefPubMedPubMedCentralGoogle Scholar
  39. 39.
    Dayisoylu EH, Cifci E, Uckan S. Ultrasound-guided arthrocentesis of the temporomandibular joint. Br J Oral Maxillofac Surg. 2013;51(7):667–8.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Kaan Orhan
    • 1
  • Ingrid Różyło-Kalinowska
    • 2
  1. 1.Department of Dentomaxillofacial RadiologyAnkara University, Faculty of DentistryAnkaraTurkey
  2. 2.Independent Unit of Propaedeutics of Dentomaxillofacial RadiologyMedical University of LublinLublinPoland

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