Oral Surgery · single question
A patient has TMJ pain with NO clicking or sounds, limited opening of only 20mm, and tenderness on palpation of the MASSETER muscle. What is the most likely diagnosis?
Show answer and explanation
Correct answer: A. Myofascial pain syndrome (masticatory muscle disorder)
✓ A) Myofascial pain syndrome is correct.
Key features: NO joint sounds (rules out disc displacement/clicking), limited opening (20mm = significant trismus), tenderness in MUSCLE (masseter), not the joint itself. Myofascial pain syndrome = muscle-origin TMD, characterized by trigger points, referred pain, and muscle tenderness. Disc displacement without reduction also causes limited opening but typically preceded by clicking. Osteoarthritis has joint sounds (crepitus) and joint-line tenderness. The muscle tenderness with no joint signs = myofascial/muscular TMD.
Key features: NO joint sounds (rules out disc displacement/clicking), limited opening (20mm = significant trismus), tenderness in MUSCLE (masseter), not the joint itself. Myofascial pain syndrome = muscle-origin TMD, characterized by trigger points, referred pain, and muscle tenderness. Disc displacement without reduction also causes limited opening but typically preceded by clicking. Osteoarthritis has joint sounds (crepitus) and joint-line tenderness. The muscle tenderness with no joint signs = myofascial/muscular TMD.