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What are symptoms of TMJ?
clicking/popping of jaw, HA/migraines, earaches/tinnitus, neck/shoulder pain, pain behind eyes, numbness/tingling of fingers
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TMD can be arthrogenous and myogenous. What are causes of TMJ?
- Bad bite (from mouth breathing from allergies even), thumb sucking when younger.
- Also grinding/clenching, injury, arthritis, emotional stress,
- Myogenous: TMD (myofascial pain and dysfunction) Etiology is multifactorial and includes malocclusion, jaw clenching, bruxism, personality disorders, increased pain sensitivity, and stress and
- anxiety.
- Arthrogenous TMD: most common: disk displacement. Others: DJD, polyarthritides such as
- RA, ankylosis, dislocation, infection, neoplasia, and
- congenital anomalies.
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TMJ is now known as what?
TMD (temporomandibular disorder)
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. What population does TMD affect the most?
- Age: 20-40
- Sex: 1:4 (male:female)
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What is bruxism?
the habit of grinding the teeth, esp unconsciously
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Differentials include?
Migraines, postherpetic neuralgia, giant cell arteritis,
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Labs for TMD?
- CBC if infection is suspected.
- Rheumatoid factor (RF), ESR, antinuclear antibody (ANA), for RA, temporal arteritis, or a connective tissue disorder is suspected.
- Uric acid should be checked for gout. Pseudogout has also been reported in the TMJ. Arthrocentesis is required to demonstrate specific crystals.
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What imaging studies for diagnosing TMD?
- Conventional X-ray = the most utilized imaging study. It is simple, evaluates bony structures, and in most cases is sufficient.
- CT scans can explore both bony structures and muscular soft tissues
- MRI = study of choice if an articular or meniscal pathology is suspected and may need endoscopic/ surgery, or in the case of traumatic TMD.
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Meds for TMD?
- NSAIDs for pain.
- Muscle relaxants (diazepam, methocarbamol, and cyclobenzaprine)
- Tricyclic antidepressants, in low doses help control pain.
- Botulinum injections.
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