Background: Single photon emission computerized tomography (SPECT) bone scintigraphy has been used to identify cases with condylar hyperplasia in mandibular asymmetry. A difference of uptake of more than 10% between the two sides of the mandibular condyles is considered significant.

Method: We reviewed the data of 90 patients investigated from 1992 to 2012 at the University Hospital Wales, Cardiff (UHW) with SPECT for facial asymmetry to assess reliability in diagnosis of condylar hyperplasia.

Results: High sensitivity was seen across all age groups however specificity and positive predictive value (PPV) significantly decreased with increasing age. The mean difference in uptake in positive cases was 15%. False positive results were noted in patients with previous temperomandibular joint (TMJ) disease and following surgery. This modality was not a reliable marker of disease progression for upto 2 years post surgery.

Conclusions: SPECT is a useful diagnostic tool for condylar hyperplasia when correlated with appropriate history and clinical findings particularly in the younger age group.

Key words : single photon emission computerized tomography (SPECT); condylar hyperplasia