Table A1.
INFLAMMATORY DOMAIN | |||||
Definition | Bone Marrow Edema |
Bone Marrow
Enhancement |
Effusion | Synovial Thickening | Joint Enhancement |
Compared to the mandibular ramus, hyperintense marrow signaling within the condyle on T2w FS or STIR images, and/or hypointense signaling on pre-contrast T1w images without FS. | Compared to the mandibular ramus, hyperintense marrow signaling within the condyle on post-contrast T1w FS images. | Increased joint fluid with isointense signaling of joint space compared to that of cerebrospinal fluid on T2w FS or STIR images. | Thickened synovial lining of the TMJ with intermediate signal on T2w images. | Signal intensity of the synovium, capsule, and joint fluid higher than that of muscle on post-contrast T1w FS images. | |
Grading | Absent | Absent | Normal: ≤1mm fluid in joint recess | Absent: No synovium visible (joint space ≤1 mm width) | Normal: High signal intensity confined to signal perimeter of normal amount of joint fluid on corresponding fluid-sensitive image |
Present | Present | Small: >1 and ≤2mm fluid in recess or involving entire joint compartment | Mild: >1 and ≤2mm thickness at the point of maximum synovial thickening | Mild: High signal intensity focally exceeding signal perimeter of physiologic amount of joint fluid on corresponding fluid-sensitive image | |
Large: >2mm fluid in recess or involving entire joint compartment | Moderate/Severe: >2mm thickness at the point of maximum synovial thickening | Moderate/Severe: High signal intensity diffusely involving one or both joint compartments | |||
DAMAGE DOMAIN | |||||
Definition | Condylar Flattening | Erosions | Disk Abnormalities | ||
Loss of the round or slightly rectangular shape of the condylar head, viewed in the sagittal-oblique plane. | Any irregularity or breaks of the bony joint surfaces leading to the loss of the smooth continuous surface of the bone, seen in both sagittal and coronal planes | Any abnormality of the articular disk, including flattening, displacement, or destruction. | |||
Grading | Normal round/slightly rectangular shape | No irregularities or deep breaks | Absent | ||
Mild: Extent of flattening involves part of the surface of the condyle | Mild: Presence of irregularities involving only part of the articular surface of the condyle | Present | |||
Moderate/Severe: Extent of flattening involves the entire surface of the condyle, or loss of height in the condyle. | Moderate/Severe: Presence of deep breaks in the subchondral bone seen in two planes, or irregularities involving the entire articular surface of the condyle |