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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 August 19, 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 August 19]. 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 -