cyst on right side of TMJ condyle

hey i had one of these and i used heat on it and it went away. its worth a try

You are discovering the oddity of TMJ in that the side that is NOT in pain is usually the problem side. This seems to be quite common and normal for jaw problems. The jaws are actually one jaw that must work together to do its job. Balance is necessary. When one side has a problem (disc displaced, etc.), the OTHER SIDE experiences the pain.

If I were you, I might concentrate on "fixing" the side with the cyst. Most cysts, I believe, are quite harmless, but it might be forcing your jaw just slightly out of balance and causing the pain on the side without the cyst. I know just about nothing of cysts except that cysts on the ovaries can burst and cause a lot of problems. I would definitely take the cyst more seriously.

God bless...
Carol

Thank you Carol for the blessings, prayers are all that keep me going. I cannot imagine anyone else surviving such a struggle. I can tell that medicine provides some comfort, but it's it feels like a drop in the ocean.

yes i have my mri scans but im not going to put it here.--im sure it was what it was--had a diagnosis

edgaras,
I certainly understand your frustration about doctors. I received very little smypathy from one of my OSs, even after the arthrocentesis -- which he said would only help, or keep my jaw the same -- caused my jaw to lock and redcued the opening by 21mm. He seemed very unconcerned. His office even badgered me, saying they were going to send my account to a collection agency -- even though their filing mistake had precipitated the delay in my insurance company paying the bill.
I'd suggest that you just keep trying until you find a doctor who is sympathetic. They are out there. It's frustrating finding them, but it's better than sticking with somebody who has no empathy.
My prayers are with you. Be strong and keep the faith.

I am very sorry to hear that arthrocentesis was not helpful, and thank you very much for posting and letting us know about it because one of the OS offered this to me as well.

I went to major university clinic here in Chicago and this OS was so agitated and upset that he would even explain to me as to possible reasons for having this pain, and appeared to be bothered, and told us (me and my mother) "he excepts to be not disturbed as he is typing the notes on his PC". It's just unbelievable, even my mother has not seen anybody in her life act the way he did. I am happy there is Commerce Regulation department, otherwise some doctors would probably not fear anything at all.


Given that he is working in state university, I did consider filing a complaint, us he didn't even look at the MRI CD which I brought in 2 months ago outside the time of our appointment. I wonder if it's the university policy perhaps that makes it difficult for doctor to review the record outside the appointment time.

At the time of my 2nd appointment, OS concluded that radiologist report was wrong, and that the disc was not stuck or displaced as reported, based on the one set of images, which he viewed over and over again, to conclude that there was a fuild arround the joint.

He didn't give an explanation for such conflicting view, all he said was "radiologist don't know everything, not even me knows everything."


I have to say, he tried his best, and I appreciate he thorough exam. And during first appointment, he even phoned the radiologist and left a message saying that he had trouble viewing the TMJ MRI results. I have compassion for the person as he works in public university which has large inflow of daily patients - must have had impact on his psyche. Even though he said that I was the one with
attitude problem and that's why "nobody wants to treat me".

Moral of the story - arrogance and small percentage of patients that do come in with psychogenic pain conditions will lead to doctors not listening to patients, and even assume they are inflicting the harm on themselves (yes, this doctor actually said, "I wonder if you are putting your fingers inside your month and touching the area to make it red."

This reminds me of the Neuroscience course which I took as undergrad - professor brought in fine sand paper and a regular sheet of paper, and gave it to students, and then asked to close the eyes and proceed to find out how many of the student felt the difference on the surface. About 1/3 of the students didn't even feel the difference while I sat there and asked myself - do they have fingers or plastic prosthesis? It appears that some people, including doctors have such limited sensory capacity, that they would probably never be dependent upon to examine patients for subtle signs.

Good news - the other appliance (nighttime one for upper jaw) that TMJ dentist made is helping the pain although it was very hard to get used to, recently I forced myself to wear it as the pain became unbearable. It appears to move my lower jaw forward, just as it was before I had orthodontic treatment, which I am sure didn't help what might have been the underlying condition.

I have uploaded new image.

I have uploaded a better quality picture from the MRI set which shows the condyle and the "condylar cyst". I was able to view using 3DView program.

As far as the cyst goes and the surrounding disk, I have trouble understanding and not really sure about displacement. I hope it can serve for comparison purposes to anybody who might have interest or similar situation.
Any input would be appreciated.


Some examples (not my pictures).

courtesy of public domain site of rochester.edu -

Here is the normally positioned disk image:




and abnormal tmj disk position,



From article writen by Shalmali Pal, AuntMinnie.com ; . Images courtesy of Dr. Jessica Lee. .

sagittal MR image obtained in closed-mouth position shows anterosuperior TMJ compartment and disk (arrows) anterior to condyle:




sagittal MR image obtained in maximal open-mouth position shows anterosuperior TMJ compartment and disk (arrows) superior to condyle:




bilateral, right anterior disk displacement on MRI preoperative:



postoperative MRI - no changes:



Postop lateral displacement of right disk:




Temporomandibular joint (TMJ) of 32-year-old woman. Diagnosis of disk displacement with reduction was based on MR imaging findings. Longitudinal high-resolution sonogram obtained in closed-mouth position shows anterosuperior TMJ compartment and disk (arrows) anterior to condyle (arrowheads). E = articular eminence, D = disk, C = condyle. Emshoff R, Jank S, Bertram S, Rudisch A, Bodner G, "Disk Displacement of the Temporomandibular Joint: Sonography Versus MRI," (AJR 2002; 178: 1557-1562).




Courtesy: Oulu University Library:


lateral pterygoid muscle (LPM) can be observed
(C = condyle)
Anterior gap (arrow) between the superior belly (SB) and inferior belly (IB) can be seen.
superior belly of the LPM (SB) is shown
Image C:
anterior displaced disc with deformity is found (arrow), but the LPM cannot be observed. (C = condyle).



Normal imaging of the LPM obtained from volunteer and asymptomatic TMJs.

A) Mouth-closed, oblique sagittal, Proton Density (2000/20) (1.5-T magnet) left TMJ image of a 28-year-old male volunteer who had no suspicious clinical signs and symptoms of TMD.
The normal LPM structures show as a fan-like muscle from the origins to the neck of the mandibular condyle or disc. A high signal layer of fat tissue separates the superior belly of the LPM (SB) form the inferior belly of the LPM (IB). A high-signal fat layer can be observed between the two bellies (arrow). Near the insertion part of the LPM the two bellies are fused with each other (C = condyle; D = disc).







Hypertrophy of superior belly of the LMP shows in images of a 52-year-old female with chronic facial pain, jaw movement pain and TMJ pain on right side for nine years, symptoms released after splint treatment:
In mouth-closed image (oblique sagittal, 3000/14, 1.5T, 3-mm-thick) of left TMJ, hypertrophy of the superior belly (SB) of the LPM is suggested by the evidently enlarged size of the belly (compare with the superior belly of the LPM of right TMJ in image B). Disc is anteriorly displaced and deformed (black arrow). Effusion can be found at bilaminar zone (white arrow). (B) The LPM shows as normal on mouth-closed image of right TMJ (oblique sagittal, 3000/14, 1.5T, 3-mm-thick). The disc shows anterior displacement (arrow). Osteoarthritic change of the condyle can be observed.
[img]http://herkules.oulu.fi/isbn951426643 9/html/graphic44.png[\img]


(B) Atrophy of the superior belly of the LPM (arrow) is revealed in a 35-year-old female who suffered pain on jaw movement, had difficult in mouth opening as well as facial pain on left TMJ for the past two years. The symptoms could not be improved by splint treatment. Painful locking and severe palpation pain on the LPM are detected on the left side. In mouth-closed, oblique sagittal image of the left TMJ (3000/14, 1.5-T magnet), atrophy of the superior belly of the LPM with large area high signal fatty replacement (arrow) is noted. The inferior belly appears normal. Anterior disc displacement (D) and osteophyte of the condyle (C) are found. The displaced disc cannot reduce in maximal mouth-open image:





Imaging abnormalities of the LPM can be found in TMJs with disc in normal position. The normal LPM may be observed in TMJs with severe osteoarthritic changes (C = condyle). (A) Atrophy of the LPM superior belly in a 36-year-old female who has had progressing pain in the TMJ, facial and temporal pain on the right side for five years. Palpation pain in the LPM and movement pain in both TMJs. The mouth-closed oblique sagittal PD (3000/15) (1,5-T magnet) MRI image of the right TMJ reveals atrophy and fatty replacement in superior belly of the LPM (arrow). Disc appears in normal position. In maximal mouth-open images bilateral TMJ hypermobility is found. (B) Normal image of the LPM is found in a 35-year-old male with painful locking, crepitating and movement pain in right TMJ, palpation pain of LPM and head-neck pain on both sides for three years. Pain symptoms have been released evidently after splint and psychical therapies, but mouth-opening limitation became worse. No palpation pain of the LPM and movement pain on both TMJs, slight palpated pain on right TMJ. The width of mouth opening is only 15mm. Mouth-closed oblique sagittal, PD image (3000/20, 3-mm-thick) of right TMJ shows severe erosion on the condyle (C). Disc becomes thinning (arrow). The LPM appears normal:

Too much for the brain ? LOL