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Oral Surgery · single question

A patient has a TMJ disorder with passive stretch of 5mm causing PAIN but no disc click. The pain is MOST likely from:

  1. Muscle pain (myofascial pain — pain originates from masticatory muscles with trigger points)
  2. Degenerative joint disease
  3. Right articular disc displacement
  4. Left articular disc displacement
Show answer and explanation

Correct answer: A. Muscle pain (myofascial pain — pain originates from masticatory muscles with trigger points)

  • A. Correct. Pain at end-range passive stretch (without clicking or catching) in a patient who otherwise opens 32mm without pain on active opening is characteristic of MYOFASCIAL PAIN (muscle pain). The limited passive stretch indicates muscle spasm/tightness rather than disc displacement or joint pathology.
  • B. Degenerative joint disease (osteoarthritis) typically causes crepitus, limited opening, and radiographic bone changes — not isolated passive stretch pain without other signs.
  • C. Disc displacement WITH reduction causes a click on opening (reciprocal click); WITHOUT reduction causes sudden limited opening. This patient opens 32mm without clicking — disc involvement is less likely.
  • D. See C answer.

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