The diagnostic accuracy of both planar and single-photon emission computed tomography (SPECT) bone scintigraphy, radionuclide angiography, arthrography, and conventional radiography was evaluated in 36 patients with temporomandibular joint (TMJ) dysfunction undergoing preoperative testing. The sensitivity of SPECT bone scintigraphy (0.94) was comparable with arthrography (0.96) and significantly better than planar bone scintigraphy (0.76), radionuclide angiography (0.35), and transcranial lateral radiographs (0.04). While data for a larger asymptomatic control population are needed, preliminary results give SPECT a diagnostic specificity of 0.70 for internal derangements of the TMJ requiring surgical correction. It is concluded that SPECT bone scintigraphy is a useful noninvasive imaging test to screen for internal derangement of the TMJ.

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