CRANIOMAXILLOFACIAL TRAUMA J Oral Maxillofac Surg 70:2829-2834, 2012 Magnetic Resonance Imaging Evaluation of Temporomandibular Joint and Associated Soft Tissue Changes Following Acute Condylar Injury Amit Nandan Dhar Dwivedi, MD,* Richik Tripathi, MDS,† Prashant K. Gupta, MD,‡ Suchi Tripathi, MBBS,§ and Sunny Garg, MBBS Purpose: This study evaluated the role of magnetic resonance imaging (MRI) in cases of acute condylar injury and assessed soft tissue damage such as disc displacement, capsular tear, and hemarthrosis within the temporomandibular joint (TMJ). Patients and Methods: This prospective study was conducted in 15 patients who presented with unilateral or bilateral condylar fracture or contusion with a unilateral or bilateral diagnosis of TMJ sprain/strain. Patients with trauma of less than 7 days previously with a unilateral or bilateral condylar fracture or contusion with a diagnosis of TMJ sprain/strain were included in the present study. The clinical diagnosis of TMJ sprain was made and further classified and graded according to the severity and type of injury. On confirmation of the diagnosis of condylar injury, patients underwent evaluation by MRI. All patients were treated by closed reduction of the condylar fracture and intermaxillary fixation for 14 to 21 days. Results: Of the 15 patients, 5 were children and 10 were adults. Of all 17 TMJ cases (2 bilateral, 13 unilateral), 2 condylar fractures were of the high variety and 13 were of the low variety. MRI diagnosis of disc displacement was established in 8 of 17 TMJ cases. There was a significant association between degrees of condylar injury and the MRI diagnosis of displaced disc and hemarthrosis. However, an MRI finding of capsular tear was not significantly associated with the degree of condylar injury. Conclusions: Soft tissue changes of the TMJ can be predicted accurately by MRI and are in direct proportion to the severity of the condylar injury of the mandible. Among the soft tissue changes, disc displacement and hemarthrosis seem to affect the outcome of functional treatment. © 2012 American Association of Oral and Maxillofacial Surgeons J Oral Maxillofac Surg 70:2829-2834, 2012 The incidence of condylar fracture is about 29% to 30% among all mandibular fractures. 1 Functional treat- ment has been advocated as an acceptable method of managing condylar fractures. Surgical management can lead to facial nerve damage, scar formation, wound infection, and other complications. In devel- oping countries, functional treatment is the treatment of choice for the management of condylar fracture because most patients refuse surgical management owing to its high cost. The advantage of surgical treatment is the accurate reduction of fractured seg- ments and the simultaneous observation of the soft tissue status of the temporomandibular joint (TMJ). Endoscopic reduction and fixation of condylar frac- Received from the Institute of Medical Sciences, Banaras Hindu University, Varanasi, India. *Assistant Professor, Department of Radiodiagnosis and Imaging. †Senior Resident, Department of Oral and Maxillofacial Surgery. ‡Professor, Department of Radiodiagnosis and Imaging, Subharti Medical College, Meerut, India. §Junior Resident, Department of Internal Medicine. Junior Resident, Department of Internal Medicine. Address correspondence and reprint requests to Dr Dwivedi: Department of Radiodiagnosis and Imaging, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, India; e-mail: amitnandan21@yahoo.com © 2012 American Association of Oral and Maxillofacial Surgeons 0278-2391/12/7012-0$36.00/0 http://dx.doi.org/10.1016/j.joms.2012.08.026 2829