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    Temporal–mandibular Joint Injury/syndrome

    Temporal–mandibular Joint Injury/syndrome is a topic covered in the 5-Minute Emergency Consult.

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    Basics

    Description

    • Myofascial pain causing temporomandibular joint (TMJ) dysfunction
    • Prevalence of 40–75% of 1 sign of TMJ disorder
    • Most common in 20–50-yr-olds
    • Females seek treatment more frequently
    • 40% have symptoms that resolve spontaneously
    • TMJ is a synovial joint:
      • Allows for hinge and sliding movements
    • Articular disorders:
      • Congenital or developmental
      • Degenerative joint disorders:
        • Inflammatory (rheumatoid arthritis)
        • Noninflammatory (osteoarthritis)
      • Trauma
      • TMJ hypermobility:
        • Laxity
        • Dislocation
        • Subluxation
      • TMJ hypomobility:
        • Trismus
        • Fibrosis
      • Infection
      • Neoplasm
    • Masticatory muscle disorders:
      • Local myalgias
      • Myositis
      • Muscle spasm
      • Contracture
      • Myofascial pain disorder
    • TMJ clicking:
      • May be normal finding; present as a transient finding in 40–60% of the population
    • TMJ motion:
      • Typical range is 35–55 mm (maxillary to mandible incisors)
      • Limited by adhesions within the joint or disk displacement or trismus from muscle spasm
    • Intra-articular disk disorder:
      • Anterior displacement with reduction:
        • Displacement in closed mouth position
        • Often with a click and variable pain with opening mouth
        • May worsen over time
      • Anterior disk displacement without reduction:
        • Disk is a mechanical obstruction to opening mouth
        • Maximal opening may be 20–25 mm
        • Often difficult to correct

    Etiology

    TMJ dysfunction is poorly understood:
    • Multifactorial:
      • Bruxism (teeth grinding)
      • Trauma
      • Malocclusion
    • Onset may be related to stress

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    Citation

    Rosen, Peter, et al., editors. "Temporal–mandibular Joint Injury/syndrome." 5-Minute Emergency Consult, 5th ed., Lippincott Williams & Wilkins, 2016. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307656/all/Temporal–mandibular_Joint_Injury_syndrome.
    Temporal–mandibular Joint Injury/syndrome. In: Rosen P, Shayne P, Barkin AZ, et al, eds. 5-Minute Emergency Consult. 5th ed. Lippincott Williams & Wilkins; 2016. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307656/all/Temporal–mandibular_Joint_Injury_syndrome. Accessed April 26, 2019.
    Temporal–mandibular Joint Injury/syndrome. (2016). In Rosen, P., Shayne, P., Barkin, A. Z., Wolfe, R. E., Hayden, S. R., Barkin, R. M., & Schaider, J. J. (Eds.), 5-Minute Emergency Consult. Available from https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307656/all/Temporal–mandibular_Joint_Injury_syndrome
    Temporal–mandibular Joint Injury/syndrome [Internet]. In: Rosen P, Shayne P, Barkin AZ, Wolfe RE, Hayden SR, Barkin RM, Schaider JJ, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. [cited 2019 April 26]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307656/all/Temporal–mandibular_Joint_Injury_syndrome.
    * Article titles in AMA citation format should be in sentence-case
    TY - ELEC T1 - Temporal–mandibular Joint Injury/syndrome ID - 307656 ED - Rosen,Peter, ED - Shayne,Philip, ED - Barkin,Adam Z, ED - Wolfe,Richard E, ED - Hayden,Stephen R, ED - Barkin,Roger M, ED - Schaider,Jeffrey J, BT - 5-Minute Emergency Consult UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307656/all/Temporal–mandibular_Joint_Injury_syndrome PB - Lippincott Williams & Wilkins ET - 5 DB - Emergency Central DP - Unbound Medicine ER -