Magnetic Resonance Imaging (MRI) is the gold standard for evaluating internal derangements of the temporomandibular joint (TMJ) because it provides excellent visualization of the soft tissues, including the articular disc, joint capsule, and surrounding musculature. MRI allows for dynamic assessment of disc position and function without ionizing radiation. Unlike CT or panoramic radiography, MRI can detect disc displacement, joint effusion, and inflammatory changes critical for accurate diagnosis and treatment planning. Ultrasound is limited by bone interference and operator dependency, making MRI superior for detailed internal joint evaluation.

Reference: Cummings Otolaryngology – Head and Neck Surgery, 7th Edition.