Clinical Radiograph of The Week: Vol1, No.6

This case was presented in the recent (vol1No6) edition of otolaryngology news.
A 60-year old male presented with annoying clicking sound heard in right ear during eating or opening / closure of the jaw. He also experiences discomfort right ear during chewing. He had no other symptoms, Otoscopy was not remarkable Examination showed tenderness on deep palpation over right TMJ area. Plain TMJ x-ray revealed the features seen (white thin arrow) on this picture. You way want to compare the appearance of left TMJ for clarity

Diagnosis: TMJ Arthritis. The best recommended modality for imaging patients with suspected TMJ arthritis is the TMJ MRI and disc displacement, joint effusion as well as bone marrow abnormalities are commonest MRI findings. However, MRI where available is still considered expensive and not affordable to most African patients with this disorder.