CBCT/TMJ Training Program

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Presentation transcript:

CBCT/TMJ Training Program

TMJ normal anatomy Condyle (mandible) Articular Eminence (temporal bone) Glenoid/Mandibular Fossa (temporal bone) Articulating Disc C AD GF AE

Bony changes of TMJ 1. Condylar head: 1.Condylar hypoplasia: Condylar morphology is normal but the size is small from all dimensions 2.Condylar hyperplasia: Condylar morphology is normal but the size is large in all dimensions Ahmad et al 2009

3. Articular surface flattening: A loss of the rounded contour of the surface 4. Osteophyte: Marginal hypertrophy with sclerotic borders & exophytic angular formation of osseous tissue arising from the surface 5. Subcortical cyst: A cavity below the articular surface that deviates from normal marrow pattern

7. Subcortical sclerosis: 6. Surface erosion: Loss of continuity of articular cortex 7. Subcortical sclerosis: Any increased thickness of the cortical plate in the load-bearing areas relative to the adjacent no-load-bearing areas 8. Generalized sclerosis: No clear trabecular orientation with no delineation between the cortical layer & the trabecular bone that extends throughout the condylar head

9. Loose joint body: 10. Deviation in form: 11. Bony ankylosis: A well-defined calcified structure(s) that is not continuous with the disc or osseous structures of the joint 10. Deviation in form: Condylar deviation in form is defined as a departure from normal shape, such as concavity in the outline of the cortical plate, & not attributable to flattening, erosive changes, osteophytes, hyper or hypoplasia 11. Bony ankylosis: Continuous osseous structure between the condyle & temporal bone associated with no discernable joint space & no translation of the condyle in the open mouth views

2.Fossa / eminence: Surface erosion: 2. Articular surface flattening: Loss of continuity of cortical margin 2. Articular surface flattening: A loss of the rounded contour of the surface 3. Subcortical sclerosis: Any increased thickness of the cortical plate in the load-bearing areas relative to the adjacent no-load-bearing areas

3.Condyle position: Position: 1 Position: 3 Position: 2 Position: 4 1. Concentric position with normal joint space 2. Concentric position with decreased joint space 3. Anterior position 4. Posterior position Position: 1 Position: 3 Position: 2 Position: 4

CBCT/TMJ protocol No Yes Criteria Scoring Scoring Option 1.Condylar hypoplasia: Condylar morphology is normal but the size is small from all dimensions. This is associated with either an increase in the joint space in a normal articular fossa, or a small articular fossa. 1.Condylar head (score Yes/No for each of the 11 criteria) 2.Condylar hyperplasia: Condylar morphology is normal but the size is large in all dimensions. This is associated with either lack of joint space in a normal articular fossa or an enlarged articular fossa to accommodate the large condyle 3. Articular surface flattening: A loss of the rounded contour of the surface. 4. Subcortical sclerosis: Any increased thickness of the cortical plate in the load-bearing areas relative to the adjacent nonload- bearing areas. 5. Subcortical cyst: A cavity below the articular surface that deviates from normal marrow pattern. 6. Surface erosion: Loss of continuity of articular cortex. 7. Osteophyte: Marginal hypertrophy with sclerotic borders & exophytic angular formation of osseous tissue arising from the surface. 8. Generalized sclerosis: No clear trabecular orientation with no delineation between the cortical layer & the trabecular bone that extends throughout the condylar head. 9. Loose joint body: A well-defined calcified structure(s) that is not continuous with the disc or osseous structures of the joint. 10. Deviation in form: Condylar deviation in form is defined as a departure from normal shape, such as concavity in the outline of the cortical plate, & not attributable to flattening, erosive changes, osteophytes, hyper or hypoplasia. 11. Bony ankylosis: Continuous osseous structure between the condyle & temporal bone associated with no discernable joint space & no translation of the condyle in the open mouth views 1. Articular surface flattening: A loss of the rounded contour of the surface. 2.Fossa /eminence (score Yes/No for each of the 3 criteria). 2. Subcortical sclerosis: Any increased thickness of the cortical plate in the load-bearing areas relative to the adjacent nonload- bearing areas 3. Surface erosion: Loss of continuity of cortical margin 1. Concentric position with normal joint space. 3.Condyla position: (select ≥1 of the 4 options) 2. Concentric position with decreased joint space. 3. Anterior position. 4. Posterior position.

Training Cases

Case #1 1.Condylar head: 2.Fossa /eminence: 3.Condyla position: 1.Condylar hypoplasia 2.Condylar hyperplasia 3. Articular surface flattening 4. Subcortical sclerosis 5. Subcortical cyst 6. Surface erosion 7. Osteophyte 8. Generalized sclerosis 9. Loose joint body 10. Deviation in form 11. Bony ankyloses 2.Fossa /eminence: 1. Articular surface flattening 2. Subcortical sclerosis 3. Surface erosion 3.Condyla position: 1. Concentric position with normal joint space 2. Concentric position with decreased joint space 3. Anterior position 4. Posterior position

Case #2 1.Condylar head: 2.Fossa /eminence: 3.Condyla position: 1.Condylar hypoplasia 2.Condylar hyperplasia 3. Articular surface flattening 4. Subcortical sclerosis 5. Subcortical cyst 6. Surface erosion 7. Osteophyte 8. Generalized sclerosis 9. Loose joint body 10. Deviation in form 11. Bony ankyloses 2.Fossa /eminence: 1. Articular surface flattening 2. Subcortical sclerosis 3. Surface erosion 3.Condyla position: 1. Concentric position with normal joint space 2. Concentric position with decreased joint space 3. Anterior position 4. Posterior position

Case #3 1.Condylar head: 2.Fossa /eminence: 3.Condyla position: 1.Condylar hypoplasia 2.Condylar hyperplasia 3. Articular surface flattening 4. Subcortical sclerosis 5. Subcortical cyst 6. Surface erosion 7. Osteophyte 8. Generalized sclerosis 9. Loose joint body 10. Deviation in form 11. Bony ankyloses 2.Fossa /eminence: 1. Articular surface flattening 2. Subcortical sclerosis 3. Surface erosion 3.Condyla position: 1. Concentric position with normal joint space 2. Concentric position with decreased joint space 3. Anterior position 4. Posterior position

Case #4 1.Condylar head: 2.Fossa /eminence: 3.Condyla position: 1.Condylar hypoplasia 2.Condylar hyperplasia 3. Articular surface flattening 4. Subcortical sclerosis 5. Subcortical cyst 6. Surface erosion 7. Osteophyte 8. Generalized sclerosis 9. Loose joint body 10. Deviation in form 11. Bony ankyloses 2.Fossa /eminence: 1. Articular surface flattening 2. Subcortical sclerosis 3. Surface erosion 3.Condyla position: 1. Concentric position with normal joint space 2. Concentric position with decreased joint space 3. Anterior position 4. Posterior position

Case #5 1.Condylar head: 2.Fossa /eminence: 3.Condyla position: 1.Condylar hypoplasia 2.Condylar hyperplasia 3. Articular surface flattening 4. Subcortical sclerosis 5. Subcortical cyst 6. Surface erosion 7. Osteophyte 8. Generalized sclerosis 9. Loose joint body 10. Deviation in form 11. Bony ankyloses 2.Fossa /eminence: 1. Articular surface flattening 2. Subcortical sclerosis 3. Surface erosion 3.Condyla position: 1. Concentric position with normal joint space 2. Concentric position with decreased joint space 3. Anterior position 4. Posterior position

Evaluation Program

Case #1 1.Condylar head: 2.Fossa /eminence: 3.Condyla position: 1.Condylar hypoplasia 2.Condylar hyperplasia 3. Articular surface flattening 4. Subcortical sclerosis 5. Subcortical cyst 6. Surface erosion 7. Osteophyte 8. Generalized sclerosis 9. Loose joint body 10. Deviation in form 11. Bony ankylosis 2.Fossa /eminence: 1. Articular surface flattening 2. Subcortical sclerosis 3. Surface erosion 3.Condyla position: 1. Concentric position with normal joint space 2. Concentric position with decreased joint space 3. Anterior position 4. Posterior position

Case #2 1.Condylar head: 2.Fossa /eminence: 3.Condyla position: 1.Condylar hypoplasia 2.Condylar hyperplasia 3. Articular surface flattening 4. Subcortical sclerosis 5. Subcortical cyst 6. Surface erosion 7. Osteophyte 8. Generalized sclerosis 9. Loose joint body 10. Deviation in form 11. Bony ankylosis 2.Fossa /eminence: 1. Articular surface flattening 2. Subcortical sclerosis 3. Surface erosion 3.Condyla position: 1. Concentric position with normal joint space 2. Concentric position with decreased joint space 3. Anterior position 4. Posterior position

Case #3 1.Condylar head: 2.Fossa /eminence: 3.Condyla position: 1.Condylar hypoplasia 2.Condylar hyperplasia 3. Articular surface flattening 4. Subcortical sclerosis 5. Subcortical cyst 6. Surface erosion 7. Osteophyte 8. Generalized sclerosis 9. Loose joint body 10. Deviation in form 11. Bony ankylosis 2.Fossa /eminence: 1. Articular surface flattening 2. Subcortical sclerosis 3. Surface erosion 3.Condyla position: 1. Concentric position with normal joint space 2. Concentric position with decreased joint space 3. Anterior position 4. Posterior position

Case #4 1.Condylar head: 2.Fossa /eminence: 3.Condyla position: 1.Condylar hypoplasia 2.Condylar hyperplasia 3. Articular surface flattening 4. Subcortical sclerosis 5. Subcortical cyst 6. Surface erosion 7. Osteophyte 8. Generalized sclerosis 9. Loose joint body 10. Deviation in form 11. Bony ankylosis 2.Fossa /eminence: 1. Articular surface flattening 2. Subcortical sclerosis 3. Surface erosion 3.Condyla position: 1. Concentric position with normal joint space 2. Concentric position with decreased joint space 3. Anterior position 4. Posterior position

Case #5 1.Condylar head: 2.Fossa /eminence: 3.Condyla position: 1.Condylar hypoplasia 2.Condylar hyperplasia 3. Articular surface flattening 4. Subcortical sclerosis 5. Subcortical cyst 6. Surface erosion 7. Osteophyte 8. Generalized sclerosis 9. Loose joint body 10. Deviation in form 11. Bony ankylosis 2.Fossa /eminence: 1. Articular surface flattening 2. Subcortical sclerosis 3. Surface erosion 3.Condyla position: 1. Concentric position with normal joint space 2. Concentric position with decreased joint space 3. Anterior position 4. Posterior position

Case #6 1.Condylar head: 2.Fossa /eminence: 3.Condyla position: 1.Condylar hypoplasia 2.Condylar hyperplasia 3. Articular surface flattening 4. Subcortical sclerosis 5. Subcortical cyst 6. Surface erosion 7. Osteophyte 8. Generalized sclerosis 9. Loose joint body 10. Deviation in form 11. Bony ankylosis 2.Fossa /eminence: 1. Articular surface flattening 2. Subcortical sclerosis 3. Surface erosion 3.Condyla position: 1. Concentric position with normal joint space 2. Concentric position with decreased joint space 3. Anterior position 4. Posterior position

Case #7 1.Condylar head: 2.Fossa /eminence: 3.Condyla position: 1.Condylar hypoplasia 2.Condylar hyperplasia 3. Articular surface flattening 4. Subcortical sclerosis 5. Subcortical cyst 6. Surface erosion 7. Osteophyte 8. Generalized sclerosis 9. Loose joint body 10. Deviation in form 11. Bony ankylosis 2.Fossa /eminence: 1. Articular surface flattening 2. Subcortical sclerosis 3. Surface erosion 3.Condyla position: 1. Concentric position with normal joint space 2. Concentric position with decreased joint space 3. Anterior position 4. Posterior position

Case #8 1.Condylar head: 2.Fossa /eminence: 3.Condyla position: 1.Condylar hypoplasia 2.Condylar hyperplasia 3. Articular surface flattening 4. Subcortical sclerosis 5. Subcortical cyst 6. Surface erosion 7. Osteophyte 8. Generalized sclerosis 9. Loose joint body 10. Deviation in form 11. Bony ankylosis 2.Fossa /eminence: 1. Articular surface flattening 2. Subcortical sclerosis 3. Surface erosion 3.Condyla position: 1. Concentric position with normal joint space 2. Concentric position with decreased joint space 3. Anterior position 4. Posterior position

Case #9 1.Condylar head: 2.Fossa /eminence: 3.Condyla position: 1.Condylar hypoplasia 2.Condylar hyperplasia 3. Articular surface flattening 4. Subcortical sclerosis 5. Subcortical cyst 6. Surface erosion 7. Osteophyte 8. Generalized sclerosis 9. Loose joint body 10. Deviation in form 11. Bony ankylosis 2.Fossa /eminence: 1. Articular surface flattening 2. Subcortical sclerosis 3. Surface erosion 3.Condyla position: 1. Concentric position with normal joint space 2. Concentric position with decreased joint space 3. Anterior position 4. Posterior position

Case #10 1.Condylar head: 2.Fossa /eminence: 3.Condyla position: 1.Condylar hypoplasia 2.Condylar hyperplasia 3. Articular surface flattening 4. Subcortical sclerosis 5. Subcortical cyst 6. Surface erosion 7. Osteophyte 8. Generalized sclerosis 9. Loose joint body 10. Deviation in form 11. Bony ankylosis 2.Fossa /eminence: 1. Articular surface flattening 2. Subcortical sclerosis 3. Surface erosion 3.Condyla position: 1. Concentric position with normal joint space 2. Concentric position with decreased joint space 3. Anterior position 4. Posterior position

Case #11 1.Condylar head: 2.Fossa /eminence: 3.Condyla position: 1.Condylar hypoplasia 2.Condylar hyperplasia 3. Articular surface flattening 4. Subcortical sclerosis 5. Subcortical cyst 6. Surface erosion 7. Osteophyte 8. Generalized sclerosis 9. Loose joint body 10. Deviation in form 11. Bony ankylosis 2.Fossa /eminence: 1. Articular surface flattening 2. Subcortical sclerosis 3. Surface erosion 3.Condyla position: 1. Concentric position with normal joint space 2. Concentric position with decreased joint space 3. Anterior position 4. Posterior position

Case #12 1.Condylar head: 2.Fossa /eminence: 3.Condyla position: 1.Condylar hypoplasia 2.Condylar hyperplasia 3. Articular surface flattening 4. Subcortical sclerosis 5. Subcortical cyst 6. Surface erosion 7. Osteophyte 8. Generalized sclerosis 9. Loose joint body 10. Deviation in form 11. Bony ankylosis 2.Fossa /eminence: 1. Articular surface flattening 2. Subcortical sclerosis 3. Surface erosion 3.Condyla position: 1. Concentric position with normal joint space 2. Concentric position with decreased joint space 3. Anterior position 4. Posterior position

Case #13 1.Condylar head: 2.Fossa /eminence: 3.Condyla position: 1.Condylar hypoplasia 2.Condylar hyperplasia 3. Articular surface flattening 4. Subcortical sclerosis 5. Subcortical cyst 6. Surface erosion 7. Osteophyte 8. Generalized sclerosis 9. Loose joint body 10. Deviation in form 11. Bony ankylosis 2.Fossa /eminence: 1. Articular surface flattening 2. Subcortical sclerosis 3. Surface erosion 3.Condyla position: 1. Concentric position with normal joint space 2. Concentric position with decreased joint space 3. Anterior position 4. Posterior position

Case #14 1.Condylar head: 2.Fossa /eminence: 3.Condyla position: 1.Condylar hypoplasia 2.Condylar hyperplasia 3. Articular surface flattening 4. Subcortical sclerosis 5. Subcortical cyst 6. Surface erosion 7. Osteophyte 8. Generalized sclerosis 9. Loose joint body 10. Deviation in form 11. Bony ankylosis 2.Fossa /eminence: 1. Articular surface flattening 2. Subcortical sclerosis 3. Surface erosion 3.Condyla position: 1. Concentric position with normal joint space 2. Concentric position with decreased joint space 3. Anterior position 4. Posterior position

Case #15 1.Condylar head: 2.Fossa /eminence: 3.Condyla position: 1.Condylar hypoplasia 2.Condylar hyperplasia 3. Articular surface flattening 4. Subcortical sclerosis 5. Subcortical cyst 6. Surface erosion 7. Osteophyte 8. Generalized sclerosis 9. Loose joint body 10. Deviation in form 11. Bony ankylosis 2.Fossa /eminence: 1. Articular surface flattening 2. Subcortical sclerosis 3. Surface erosion 3.Condyla position: 1. Concentric position with normal joint space 2. Concentric position with decreased joint space 3. Anterior position 4. Posterior position

Case #16 1.Condylar head: 2.Fossa /eminence: 3.Condyla position: 1.Condylar hypoplasia 2.Condylar hyperplasia 3. Articular surface flattening 4. Subcortical sclerosis 5. Subcortical cyst 6. Surface erosion 7. Osteophyte 8. Generalized sclerosis 9. Loose joint body 10. Deviation in form 11. Bony ankylosis 2.Fossa /eminence: 1. Articular surface flattening 2. Subcortical sclerosis 3. Surface erosion 3.Condyla position: 1. Concentric position with normal joint space 2. Concentric position with decreased joint space 3. Anterior position 4. Posterior position

Case #17 1.Condylar head: 2.Fossa /eminence: 3.Condyla position: 1.Condylar hypoplasia 2.Condylar hyperplasia 3. Articular surface flattening 4. Subcortical sclerosis 5. Subcortical cyst 6. Surface erosion 7. Osteophyte 8. Generalized sclerosis 9. Loose joint body 10. Deviation in form 11. Bony ankylosis 2.Fossa /eminence: 1. Articular surface flattening 2. Subcortical sclerosis 3. Surface erosion 3.Condyla position: 1. Concentric position with normal joint space 2. Concentric position with decreased joint space 3. Anterior position 4. Posterior position

Case #18 1.Condylar head: 2.Fossa /eminence: 3.Condyla position: 1.Condylar hypoplasia 2.Condylar hyperplasia 3. Articular surface flattening 4. Subcortical sclerosis 5. Subcortical cyst 6. Surface erosion 7. Osteophyte 8. Generalized sclerosis 9. Loose joint body 10. Deviation in form 11. Bony ankylosis 2.Fossa /eminence: 1. Articular surface flattening 2. Subcortical sclerosis 3. Surface erosion 3.Condyla position: 1. Concentric position with normal joint space 2. Concentric position with decreased joint space 3. Anterior position 4. Posterior position

Case #19 1.Condylar head: 2.Fossa /eminence: 3.Condyla position: 1.Condylar hypoplasia 2.Condylar hyperplasia 3. Articular surface flattening 4. Subcortical sclerosis 5. Subcortical cyst 6. Surface erosion 7. Osteophyte 8. Generalized sclerosis 9. Loose joint body 10. Deviation in form 11. Bony ankylosis 2.Fossa /eminence: 1. Articular surface flattening 2. Subcortical sclerosis 3. Surface erosion 3.Condyla position: 1. Concentric position with normal joint space 2. Concentric position with decreased joint space 3. Anterior position 4. Posterior position

Case #20 1.Condylar head: 2.Fossa /eminence: 3.Condyla position: 1.Condylar hypoplasia 2.Condylar hyperplasia 3. Articular surface flattening 4. Subcortical sclerosis 5. Subcortical cyst 6. Surface erosion 7. Osteophyte 8. Generalized sclerosis 9. Loose joint body 10. Deviation in form 11. Bony ankylosis 2.Fossa /eminence: 1. Articular surface flattening 2. Subcortical sclerosis 3. Surface erosion 3.Condyla position: 1. Concentric position with normal joint space 2. Concentric position with decreased joint space 3. Anterior position 4. Posterior position

Case #21 1.Condylar head: 2.Fossa /eminence: 3.Condyla position: 1.Condylar hypoplasia 2.Condylar hyperplasia 3. Articular surface flattening 4. Subcortical sclerosis 5. Subcortical cyst 6. Surface erosion 7. Osteophyte 8. Generalized sclerosis 9. Loose joint body 10. Deviation in form 11. Bony ankylosis 2.Fossa /eminence: 1. Articular surface flattening 2. Subcortical sclerosis 3. Surface erosion 3.Condyla position: 1. Concentric position with normal joint space 2. Concentric position with decreased joint space 3. Anterior position 4. Posterior position

Case #22 1.Condylar head: 2.Fossa /eminence: 3.Condyla position: 1.Condylar hypoplasia 2.Condylar hyperplasia 3. Articular surface flattening 4. Subcortical sclerosis 5. Subcortical cyst 6. Surface erosion 7. Osteophyte 8. Generalized sclerosis 9. Loose joint body 10. Deviation in form 11. Bony ankylosis 2.Fossa /eminence: 1. Articular surface flattening 2. Subcortical sclerosis 3. Surface erosion 3.Condyla position: 1. Concentric position with normal joint space 2. Concentric position with decreased joint space 3. Anterior position 4. Posterior position

Case #23 1.Condylar head: 2.Fossa /eminence: 3.Condyla position: 1.Condylar hypoplasia 2.Condylar hyperplasia 3. Articular surface flattening 4. Subcortical sclerosis 5. Subcortical cyst 6. Surface erosion 7. Osteophyte 8. Generalized sclerosis 9. Loose joint body 10. Deviation in form 11. Bony ankylosis 2.Fossa /eminence: 1. Articular surface flattening 2. Subcortical sclerosis 3. Surface erosion 3.Condyla position: 1. Concentric position with normal joint space 2. Concentric position with decreased joint space 3. Anterior position 4. Posterior position

Case #24 1.Condylar head: 2.Fossa /eminence: 3.Condyla position: 1.Condylar hypoplasia 2.Condylar hyperplasia 3. Articular surface flattening 4. Subcortical sclerosis 5. Subcortical cyst 6. Surface erosion 7. Osteophyte 8. Generalized sclerosis 9. Loose joint body 10. Deviation in form 11. Bony ankylosis 2.Fossa /eminence: 1. Articular surface flattening 2. Subcortical sclerosis 3. Surface erosion 3.Condyla position: 1. Concentric position with normal joint space 2. Concentric position with decreased joint space 3. Anterior position 4. Posterior position

Case #25 1.Condylar head: 2.Fossa /eminence: 3.Condyla position: 1.Condylar hypoplasia 2.Condylar hyperplasia 3. Articular surface flattening 4. Subcortical sclerosis 5. Subcortical cyst 6. Surface erosion 7. Osteophyte 8. Generalized sclerosis 9. Loose joint body 10. Deviation in form 11. Bony ankylosis 2.Fossa /eminence: 1. Articular surface flattening 2. Subcortical sclerosis 3. Surface erosion 3.Condyla position: 1. Concentric position with normal joint space 2. Concentric position with decreased joint space 3. Anterior position 4. Posterior position

Case #26 1.Condylar head: 2.Fossa /eminence: 3.Condyla position: 1.Condylar hypoplasia 2.Condylar hyperplasia 3. Articular surface flattening 4. Subcortical sclerosis 5. Subcortical cyst 6. Surface erosion 7. Osteophyte 8. Generalized sclerosis 9. Loose joint body 10. Deviation in form 11. Bony ankylosis 2.Fossa /eminence: 1. Articular surface flattening 2. Subcortical sclerosis 3. Surface erosion 3.Condyla position: 1. Concentric position with normal joint space 2. Concentric position with decreased joint space 3. Anterior position 4. Posterior position

Case #27 1.Condylar head: 2.Fossa /eminence: 3.Condyla position: 1.Condylar hypoplasia 2.Condylar hyperplasia 3. Articular surface flattening 4. Subcortical sclerosis 5. Subcortical cyst 6. Surface erosion 7. Osteophyte 8. Generalized sclerosis 9. Loose joint body 10. Deviation in form 11. Bony ankylosis 2.Fossa /eminence: 1. Articular surface flattening 2. Subcortical sclerosis 3. Surface erosion 3.Condyla position: 1. Concentric position with normal joint space 2. Concentric position with decreased joint space 3. Anterior position 4. Posterior position

Case #28 1.Condylar head: 2.Fossa /eminence: 3.Condyla position: 1.Condylar hypoplasia 2.Condylar hyperplasia 3. Articular surface flattening 4. Subcortical sclerosis 5. Subcortical cyst 6. Surface erosion 7. Osteophyte 8. Generalized sclerosis 9. Loose joint body 10. Deviation in form 11. Bony ankylosis 2.Fossa /eminence: 1. Articular surface flattening 2. Subcortical sclerosis 3. Surface erosion 3.Condyla position: 1. Concentric position with normal joint space 2. Concentric position with decreased joint space 3. Anterior position 4. Posterior position

Case #29 1.Condylar head: 2.Fossa /eminence: 3.Condyla position: 1.Condylar hypoplasia 2.Condylar hyperplasia 3. Articular surface flattening 4. Subcortical sclerosis 5. Subcortical cyst 6. Surface erosion 7. Osteophyte 8. Generalized sclerosis 9. Loose joint body 10. Deviation in form 11. Bony ankylosis 2.Fossa /eminence: 1. Articular surface flattening 2. Subcortical sclerosis 3. Surface erosion 3.Condyla position: 1. Concentric position with normal joint space 2. Concentric position with decreased joint space 3. Anterior position 4. Posterior position

Case #30 1.Condylar head: 2.Fossa /eminence: 3.Condyla position: 1.Condylar hypoplasia 2.Condylar hyperplasia 3. Articular surface flattening 4. Subcortical sclerosis 5. Subcortical cyst 6. Surface erosion 7. Osteophyte 8. Generalized sclerosis 9. Loose joint body 10. Deviation in form 11. Bony ankylosis 2.Fossa /eminence: 1. Articular surface flattening 2. Subcortical sclerosis 3. Surface erosion 3.Condyla position: 1. Concentric position with normal joint space 2. Concentric position with decreased joint space 3. Anterior position 4. Posterior position