Update : Temperomandibular arthralgia-Discussion

Shashidhar Tatavarty
Temperomandibular arthralgia .... Imaging of choice ,work up and management.. kindly share your experiences....

August 18 at 8:25pm · · ·

You, Ravi Meher and Lalit Mohan Parashar like this.
- Lalit Mohan Parashar OPG, Dentascan, Dead Lateral View - Skull, elicit tenderness of joint by palpation lateral to joint and with a finger in EAC, treat minimum 14 days with Diclofenac
  August 18 at 8:31pm · · 3 people
- Bharat Khatri Yes plus exclude any dental cause,faulty bite
  August 18 at 8:33pm · · 1 person
- Anoop Agarwal OPG
  August 18 at 11:07pm ·
- Shikha Sharma sir,what will be the findings in OPG?Is there any role of steroids n physiotherapy?
  August 18 at 11:35pm ·
- Deepak Chauhan Habits such as teeth clenching and bruxism (apart from malocclusion and dental cause)commonly results in TMJ disorder.OPG less senstive in detecting joint inflammation. CT scan better modality can detect disc displacement (85 -90% senstivity. but the gold standard is MRI (93 - 96% senstivity) can detect minimal fluid collection in joint space and synovial tissue inflammation.
  August 19 at 12:19am · · 2 people
- Shashidhar Tatavarty I ve been getting opg done.As a rule when there is no clicking, trismuss or dislocation of TMJ, OPG comes as norml. MRI is the only modality which shows joint inflammation or mensicitis. but threshold for getting it done is quite high.. Rheumatoid arthritis, myofascial pain, degnerative joint disorders and Dental problem are few things to exclude..any one with experience of intrarticular steroids when NSAIDS and physiotherapy are not enough...
  August 19 at 5:05am · · 1 person
- Ravi Meher i think we mjust treat TMJ as any other synovial joint, and take some leads from orthopedicians. They start pain killers, physiotherapy. If it does not improve intraarticular streoid amy be tried. I have no experience of intrarticular steroids.
  August 19 at 5:51am · · 1 person
- Ravi Meher ‎1. Muscle-related TMD (myogenous TMD), sometimes called TMD secondary to myofascial pain and dysfunction
  
  2. Joint-related (arthrogenous) TMD, or TMD secondary to true articular disease
  
  Of note, these 2 types often coexist in one patient, making diagnosis and treatment more challenging.
  
  Myogenous TMD is more common. In its pure form, it lacks apparent destructive changes of the TMJ on radiograph and can be caused by multiple etiologies such as bruxism and daytime jaw clenching.
  
  Arthrogenous TMD can be further specified as disk displacement disorder, chronic recurrent dislocations, degenerative joint disorders, systemic arthritic conditions, ankylosis, infections, and neoplasia.
  August 19 at 5:53am · · 2 people
- Gautam Aggarwal Dr Lalit Mohan Parashar , could you please elaborate about dentascan ? When do you ask for this scan & what findings do you look for in it ?
  August 19 at 10:11am ·
- Lalit Mohan Parashar Dentascan is basically a ct scan with extraction software specific to jaws and shows both TM joints in one view for better comparison.we look for joint space abnormality, signs of denuded bone/ dislocation besides surrounding structure. it is also goodto see tooth roots.
  August 19 at 11:09am · · 3 people
- Sudipta Chandra I usually do OPG first. Exclude any Dental problems. Start Anti-Inflammatory combined with Enzymes BD x 15 days. Advice to chew equally from both the sides. Semisolid diet for 5 days. If they r not relieved after 15 days- Exclude RA etc.-Intra-articular Methyl-Prednisolone weekly for upto 6 such, if needed. It usually helps. Advised MRI in some cases, but usually they do not agree for the cost...
  August 19 at 3:22pm · · 3 people
- DrKumaresh Krishnamoorthy ‎Sudipta Chandra WIll do the same
  August 19 at 6:17pm · · 1 person