Imaging Case Study of the Month Massive Osteolysis (Gorham's Disease) of the Temporomandibular Joint

Initial pluridirectional tomograms of the left temporomandibular joint area showed an absence of a mandibular condyle and destruction of the glenoid fossa region and the middle cranial fossa floor (Fig 1). In light of these findings, it was decided to undertake computed tomography (CT) of the base of the skull, which revealed similar findings plus erosion and destruction of the floor of the middle fossa back to and including the apex ofthe left petrous bone (Fig 2). This study was done with contrast, and no abnormal enhancement was noted. An arteriogram was then performed of the left carotid system, including separate internal and external carotid injections. This study revealed an avascular mass that caused R. MARVIN FREEDY, MD

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