Monday, July 16, 2012

Too Much Jowling


A 30 year old woman presents with left sided facial pain over the lower cheek. It radiates a little to the jaw and ear. It feels like a dull ache, worse with chewing. The patient is undergoing some psychosocial stressors including changing jobs and a death of a family member. Her partner says she sometimes grinds her teeth in her sleep. Palpating over the angle of the mandible leads to moderate pain on the left side. There is some tenderness over the temporal muscle on the left side as well. The last set of dental X-rays were normal.

Challenge: What's the diagnosis?

Image shown under Fair Use.

4 comments:

Reflex Hammer said...

TMJ dysfunction?

jimmy said...

Trigeminal neuralgia

Viktor Tyberkevych said...

bruxism

Craig Chen said...

yep - it's TMJ (or bruxism). Trigem neuralgia is definitely in the differential, though classically, its pain is much more sharp, intense, paroxysmal, stabbing.
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Too Much Jowling

Temporomandibular Joint Syndrome (TMJ Syndrome) is a myofascial pain due to persistent, unconscious, repetitive use of masticatory muscles. The image shows some smallness of the facies on the ipsilateral side.

Source: UpToDate.