Painful clicking jaw: a pictorial review of internal derangement of the temporomandibular joint

Abstract

Temporomandibular joint disorders are a common cause of chronic musculoskeletal pain worldwide. Among these, internal disc derangement is the most frequent type of disorder. Internal derangement is defined as an abnormal positional and functional relationship between the disc and articulating surfaces. Common clinical symptoms include pain and clicking.Imaging plays a key role in diagnosing temporomandibular joint disorders. It is important for the radiologist to detect early imaging signs of internal derangement, thereby avoiding the evolution of this condition to degenerative joint disease. The aim of this article is to familiarise the reader with the spectrum of imaging findings that are encountered at different stages of the disease.

A Novel Method of Temporomandibular Joint Hypermobility Diagnosis Based on Signal Analysis

“…Such a stop results in a specific sound-clinically audible as a thud. The phenomenon is physiological and results from the specific anatomy of the articular tubercle, which can be caused by the excessive mouth opening during yawning, singing, vomiting, eating or through factors such as generalised joint hypermobility (GJH), Ehler Danlos syndrome, Marfan syndrome or intubation under general anaesthesia [1,2].…”

“…Nosouhian et al reported that TMJH occurs much more frequently in women (78.2%) than in men [11]. Moreover, Mehndiratta et al, using magnetic resonance imaging (MRI), noticed that TMJH is connected with an anatomic variant where the articular eminence has a steep and short posterior slope and a longer anterior slope [2].…”

Temporomandibular Joint Hypermobility - Diagnosis Based on Auscultation and Signals Analysis

“…Daily activities such as eating of hard foods, gasping, yawning in case of patients with hypermobility of the temporomandibular joints are associated with a speci c sound described as thud (6) . Sounds in the joints created during everyday activities performed by patients draw the attention of others, which is usually embarrassing.…”

“…The phenomenon is physiological and results from the speci c anatomy of the articular tubercle. Among the factors that lead to such a speci c anatomy of the articular tubercle we can distinguish the excessive mouth opening during yawning, singing, vomiting, eating, factors such a generalized joint hypermobility (GJH), Ehler Danlos syndrome or Marfan syndrome and intubation under general anesthesia (5,6). The dynamic compression during excursive gliding and incursive movements con rm subluxation (5)(6)(7) Subluxation may also be considered a non-physiological condition if the patient reports chewing muscle disorders as well as TMJ pain and discomfort.…”

“…Among the factors that lead to such a speci c anatomy of the articular tubercle we can distinguish the excessive mouth opening during yawning, singing, vomiting, eating, factors such a generalized joint hypermobility (GJH), Ehler Danlos syndrome or Marfan syndrome and intubation under general anesthesia (5,6). The dynamic compression during excursive gliding and incursive movements con rm subluxation (5)(6)(7) Subluxation may also be considered a non-physiological condition if the patient reports chewing muscle disorders as well as TMJ pain and discomfort. The sound that appears in the nal step of opening the mouth may be a sign of subluxation of the condyle, which moves forward (8) When the patient has repeated episodes of subluxation, this may result in lengthening of the ligaments potentially leading to disorders of the disc.…”