TMJD MRI WTF BBQ

June 27, 2015 1:58 PM

I have an upcoming MRI for TMJD but I have been having a lot of good low-pain days lately. Do I trigger my TMJD so it is more evident on the test?

I have suffered from TMJD (Temporomandibular Joint Disorder) for two years. At its worst I had cortisone shots in both jaws and then still had to take 3 Percocet daily. In March I went on parental leave and my pain pretty quickly decreased - it has been wonderful. I have no doubt that it will come back with a vengeance once I'm back at work in November.

After 6 months of waiting for an MRI, it's happening on Saturday. I'm worried that the test will show that my issue is less severe than it actually is, I will be denied for surgery based on this, and then when I go back to work I will be in constant agony again. I could, however, very easily trigger it. Eat some chewy bread, gnaw on some beef jerky, chew some gum, and blammo - back in painland.

I don't exactly know how MRIs work though - will that affect the test? I don't want to put myself in pain for nothing if the MRI won't "see" it anyway. Should I trigger the TMJD before the test, or save myself the pain?

posted by arcticwoman to Health & Fitness (3 answers total)

Best answer: So, what's happening when you're having serious TMJ issues is that the piece of cartilage in the J between the T and the M is actually slipping in and out of place. In severe cases, it can just waddle right on out of the joint altogether and you get bone on bone action which really sucks. But most of the time when it's bad it's just slipping. (This was the case for me.) I suspect that since yours gets better when you're not actively stressed that you're just experiencing some cartilage slippage, too.

Aggravating your TMJ wouldn't really do much for MRI purposes I don't think. You'll just stress the muscles and cause yourself a lot of pain for no reason. I suspect they'll give you some kind of device so they can run images with your mouth open and with your mouth in an active bite so they can actually see the shape your jaw is in (what kind of offset you've got, where your cartilage boogies off to instead of doing its job, etc). They'll be able to see what they need to see and you don't have to do anything but lie there and be uncomfortable.

Protip from someone who's had a few head MRIs: ask for a pillow. You're going to be holding your head at dumb angles and very very still and lying on the hard plastic of the cage they stick your head in to keep you immobile gets really unpleasant.
posted by phunniemee at 2:18 PM on June 27, 2015 [3 favorites]

I had an MRI done to test for TMJ several years ago and asked my doctor basically the same question. He told me that it wouldn't make a difference. In my case, they had me put a device in my mouth with my mouth closed. They imaged for a bit and then had me click the device to open my mouth a small amount. Rinse and repeat until my mouth was fully open. I may have had to repeat the process and close my mouth, but it's been so long I don't remember. I didn't have to do a bunch of strange, uncomfortable positions or anything. Just laid on my back and clicked the doohickey. When I went back for the follow up my doctor showed me the video they made of the images. I found it fascinating to see the inside of my body at work and he made me a copy to take home.

I didn't find the procedure uncomfortable, but I would strongly recommend that you be as relaxed as possible prior to going in. If you are in a bunch of pain prior and then have to open your mouth wide open it would make the procedure less than fun, I would think. Also, I found that resting my teeth on the device and making the device do the work instead of trying to hold my mouth open myself made it much more comfortable. Good luck!
posted by colt45 at 10:00 PM on June 27, 2015

You don't need to trigger your TMJD in order to show the damage in your joints. The damage is done and will be visible no matter what your pain level is at. Inflammation levels can vary, but specialists are aware of this and hopefully would not deny surgery based on this.

They'll be looking at the joint - any deterioration in the bone / cartilage. The mri is usually done in addition to arthroscopic surgery because in this joint, they often need to actually get inside to see what is causing the pain. In my case, I had 2 arthrocentesis procedures (open joint, wash joint, inject with hyaluronic acid) and then an arthroscopic surgery where they found that the articular disk was perforated and damn near worthless. They tried to reposition what they could, and left it in, in hopes that it would become a good place for some scar tissue to grow.

I recently found a good TMJ support group on facebook. Lots of personal stories, advice, etc., to be found there. It's called "TMJ."
posted by mochilove at 11:43 AM on June 28, 2015