PMC4319332_01
Extra oral photograph showing restricted mouth opening
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F1
On clinical examination of TMJ, the following signs and symptoms were assessed: Left side TMJ was associated with pain, TMJ range of motion was limited, associated with pain while maximum unassisted mouth opening (18 mm) and while lateral excursion [Figure 1], deviation of mandible toward left side while opening mouth was noticed.
Orthopantomogram showing no appreciable changes in the left condyle
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F2
The findings were of degenerative joint disease but nonspecific due to the overlapping of structures [Figure 2].
Temporomandibular joint (TMJ) tomogram revealing mild erosions at the anterior condyle of left TMJ
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F3
TMJ tomography both open and closed mouth revealed slight erosion in the anterior surface of the left condyle but was not clearly appreciated [Figure 3].
CBCT coronal view of closed mouth - a) right condyle revealing slight decrease in joint space
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F4
Coronal left closed mouth view revealed loss of joint space, loss of cortical bone on the superior surface and condylar head erosions compared to right side, which shows normal joint space and condylar structure [Figure 4a and b].
Left condyle revealing loss of joint space and severe condylar erosions
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F5
Coronal left open mouth view revealed narrowing of the articular space and erosions on superior head of condyle and right side depicting no changes in the joint space [Figure 5a and b].
Coronal view of open mouth - (a) right side depictingno changes in the joint space (b) Left side revealing narrowing of the articular space and erosions on superior head of the condyle
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F6
Sagittal view open and closed mouth revealed decrease in joint space with erosions of the superior surface of the condyle on the left side [Figures 6a and b, 7a and b].
Sagittal view open mouth: (a) right side depicting nochanges (b) decreased joint space and erosions of the superior surface of the condyle
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F7
Sagittal view open and closed mouth revealed decrease in joint space with erosions of the superior surface of the condyle on the left side [Figures 6a and b, 7a and b].
Hand wrist radiograph revealing the joint space narrowing of the distal phalange of the right thumb, narrowing of 3rd and 4th proximal phalanges and erosion of the middle phalange seen of index finger
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F8
Hand wrist radiograph revealed the joint space narrowing of the distal phalange of the right thumb, narrowing of 3rd and 4th proximal phalanges and erosion of the middle phalange seen of index finger [Figure 8].