MR Imaging in Temporomandibular Joint Disorders: From Diagnostic Fundamentals to Advanced Applications

Temporomandibular joint (TMJ) disorders include a broad range of developmental, inflammatory, and neoplastic conditions that can interfere with joint function and affect quality of life. Magnetic resonance imaging (MRI) is the reference standard for TMJ evaluation because it provides detailed multiplanar visualization of osseous and soft-tissue structures without ionizing radiation. This review summarizes MRI assessment of TMJ anatomy, normal variations, and internal derangements, including disc displacement, pseudodisc formation, adhesions, marrow changes, and joint effusion. MRI features of inflammatory arthropathies, cystic and tumor-like lesions, and primary or metastatic malignancies are described with attention to diagnostic relevance. Imaging protocols and sequence selection are explained in relation to accurate depiction of disc and condyle relationships and adjacent soft tissues. Recent developments in MRI, including ultrashort echo time imaging, zero echo time imaging, real-time cine evaluation, diffusion-based techniques, and quantitative T2 mapping, are reviewed for their ability to detect early biochemical changes and improve diagnostic precision. The combined anatomic, pathologic, and technical information provides a comprehensive overview of current and emerging applications of MRI in TMJ disorders.