Temporomandibular joint arthrography of normal subjects: Prevalence of pain with ionic versus nonionic contrast agents

Bilateral temporomandibular joint (TMJ) arthrography was performed in 31 healthy subjects to determine the prevalence and degree of postprocedural pain and to establish if morbidity could be decreased by use of a nonionic contrast agent. Ionic contrast material (Hypaque 60%) was injected on one side and nonionic contrast material (Amipaque) on the other side. The pain experienced in the 5 days following arthrography was graded and recorded. Discomfort, when present, was described as mild or moderate and usually lasted for 2 days after the procedure. In no instance was the pain considered severe. There was significantly less pain on the side that was injected with nonionic contrast material. The invasiveness of the examination should not be a deterrent since discomfort from TMJ arthrography is minimal when performed by an experienced arthrographer; use of a nonionic contrast agent can further decrease the pain.