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Temporomandibular joint, intra articular injection
 Temporomandibular joint
PATIENT'S POSTURE The patient lies on his side with the affected joint uppermost.
PRODUCT 0.5 ml triamcinolone acetonide (40 mg/ml)
SYRINGE 1 ml tuberculin syringe
NEEDLE 0.6x25 mm (23 G 1)
TECHNIQUE One palpates the lower edge of the zygoma and the posterior edge of the condyle of the mandible, which lies just anterior to the tragus and under the zygomatic process. The injection is given under the articular disc and behind the condyle of the mandible in the lower part of the joint, while the patient has his mouth wide open. Therefore, a felt pad is used between the patient's teeth. The needle is inserted almost vertically (directed slightly forwards) at the base of the tragus. The tip of the needle lies intra-articularly at about 1.5 cm. Here the injection is given, normally without any resistance. If resistance is felt, the tip of the needle lies either subperiosteally, or in the articular cartilage or the disc. The needle must then be slightly withdrawn and the tip of the needle re-orientated.
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