Bifid mandibular condyle: CT and MR imaging appearance in two patients: case report and review of the literature

Abstract

We describe two cases of a bifid mandibular condyle. The first case is a 48-year-old woman with headaches and a pain and clicking sensation in her right jaw during mastication. The second case is an asymptomatic 17-year-old woman with a history of bilateral microtia and hemifacial microsomia. In both patients, the bifid condyle was first identified by CT and affected the temporomandibular joint. The imaging findings of both patients' bifid mandibular condyles led us to conclude that both patients likely had an abnormal development of the mandibular condyles. We believe that an intervening fibrous or vascular structure may have split the condyle into two heads.

Fig 1.

Axial (A) and coronal (B) thin-cut CT images through the mandible demonstrate a bifid mandibular condyle on the right side with mediolaterally oriented heads. C, Axial, T1-weighted MR imaging demonstrates the bifid mandibular condyle on the right side, but also demonstrates subtle fatty atrophy of the muscles of mastication ipsilaterally. D, Coronal T1-weighted MR imaging images demonstrate the bifid condyle on the right side and also demonstrate that the meniscus has the shape of a T, with a third limb interdigitating between the two mandibular heads.

Fig 2.

A, Coronal thin-cut CT images demonstrate that the left mandibular condyle is bifid, with mediolaterally oriented heads. Although both mandibular heads are small and deformed, the left is much smaller than the right. B and C, Axial, T1-weighted MR imaging images again demonstrate the bifid mandibular condyle. D, Coronal images demonstrate the mediolaterally oriented heads and also show the T-shaped meniscus, with the descending limb of the T interdigitating between the mediolaterally oriented heads.