Macroscopic and microscopic appearance of radiologic findings in temporomandibular joints from elderly individuals. An autopsy study

Abstract

The macroscopic and microscopic appearance of radiologic findings in 40 temporomandibular joints (TMJ) taken at autopsy from 20 elderly individuals was investigated. The radiologic signs of erosion and sclerosis were strongly associated with macroscopic articular surface destruction only on the condyle while the soft tissue lining was most often intact in areas with a sclerosis of the temporal component. Radiologic concavity, osteophyte, and flattening presented none or mild macroscopic changes. The microscopic appearance of erosion and cyst formation was characterized by the presence of a cell-rich fibrous and well-vascularized connective tissue. In 4 joints with fibrous ankylosis, an articular soft tissue lining was completely lacking. In areas with radiologic sclerosis, thickening of the cortical and subcortical bone was observed. Both erosions and sclerosis were found in most joints with anterior disc position or disc perforation. It was concluded that radiologic signs of erosion and sclerosis in the condyle are more reliable signs of joint disease than such changes in the temporal component.