Orofacial Pain > Diseases > Flashcards

Diseases Flashcards

(46 cards)

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1
Q

What is the definition of myalgia?

A

pain of muscle origin affected by jaw movement and is replication with testing of muscles

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2
Q

What do you look for in the exam to dx someone with myalgia?

A

Pain in masseter and/or temporalis where pain is provoked with movement, function, and parafunction and familiar pain on palpation (MUST)

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3
Q

What is the definition of myofascial pain?

A

masticatory pain disorder by regional muscle pain originating from hyper-irritable muscle tissue with pain remaining localized to palpated site

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4
Q

What are symptoms of myofascial pain?

A

Dull, deep, aching pain to jaw, cheek, temple region that aggravated by chewing, opening, prolonged speaking

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5
Q

What is dx for myofascial pain with referral?

A

Same as myalgia (Pain in masseter and/or temporalis where pain is provoked with movement, function, and parafunction and familiar pain on palpation (MUST)) BUT pain spreads beyond the boundry of the muscle

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6
Q

What is arthralgia?

A

pain of JOINT that is affected by jaw movement and replication of this pain occur with testing

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7
Q

What do you look for in exam to dx someone with arthralgia?

A

Familiar pain in TMJ from palpation of lateral pole OR during Max opening, lateral, or protrusive movements

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8
Q

What is headache attributed to TMD?

A

headache in temporal area secondary to pain-related TMD affected by jaw movement and headache is replicated via testing

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9
Q

What do you look for to dx someone with headche attributed to tmd?

A

headache in temporalis AND reports familiar headache when temporalis is palpated OR max opening, lateral, or protrusive movements

  • needs prior dx of myalgia, myofascial pain, or arthralgia
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10
Q

What is a spasm?

A

sudden involuntary tonic contractions of muscle that can be associated with acute malocclusion, pain, and limited range of motion

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11
Q

What is hypertrophy?

A

enlargement of masticatory muscle(s) due to overuse, familial, or genetic

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12
Q

What is tendonitis?

A

pain of tendon, temporalis is most common and it refers to teeth and other, MUST have myalgia with clinical confirmation of specific tendon

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13
Q

What is contracture?

A

shortening of muscle due to fibrosis, seen in masseter or medial pterygoid, pain only with over-extension, hx of trauma, infection, radiation
- < 40 mm MAO with hard end feel

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14
Q

What is myositis?

A

pain of muscular origins with inflammation/infection such as edema, erythema, temperature, even can lead to calcification of muscle

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15
Q

What must a patient have for myositis?

A

MUST have myalgia with edema, erythema, and/or inc temp

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16
Q

What is acute myositis due to?

A

Trauma or infection

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17
Q

What is chronic myositis due to?

A

from autoimmune limitation of movement secondary to pain If these muscles calcify, then we get this vvv

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18
Q

What is myositis ossificans traumatic?

A

Rare, non-neoplastic disorders with ossification of soft tissue, such as masticatory muscle due to trauma, burns, or surgery

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19
Q

What is myofascial pain syndrome (MFPS) characterized by?

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A

presence of trigger points in voluntary muscle

20
Q

What is dx criteria for myofascial pain syndrome?

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A

regional dull, aching pain aggravated by function when masticatory muscles are involved

21
Q

What muscles is TMJ and ear pain referred by?

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A

deep masseter
lateral pterygoid
medial pterygoid
sternocleidomastoid
→ Pain Spreads Deep

22
Q

What muscles is toothache referred by?

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A

superficial masseter
temporalis
anterior digastric
→ TSA

23
Q

What is dx criteria for myalgia?

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A

muscle pain in jaw, temple, ear, or pre-auricular area in last 30 days that is aggravated with jaw movement and muscle palpation cause report of localised muscle pain at palpation site

24
Q

What is dx criteria of myositis?

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A

local muscle pain following injury or infection and presents with edema, erythema, or increased temp
- May have elevated enzyme levels/ markers of inflammation, diffuse tenderness, increased paine ith used, and limited range of motion

25
What is dx criteria for myopasm?
acute onset of pain at rest and with function with immediate report of limited range of motion < 40 mm
26
What is dx criteria for contracture?
progressive loss of range of motion with MUO and MAO < 40 mm and has a “hard end feel”
27
What is dx criteria for fibromyalgia?
- Widespread pain with bilateral diffuse musculoskeletal aches and stiffened above and below waist for 3 months - Exaggerated tenderness in 11/18 sites = relied on tender point exam - Refer to rheumatologist
28
What are symptoms of fibromyalgia?
Tingling, numbness, tightness and swelling may affect jaw
29
What are medications for fibromyalgia?
Milnacipran Duloxetine Pregabalin (Medication Dulls Pain)
30
What is dx for orofacial dyskinesia?
must provide hx of dyskinesia in orofacial region, positive for myalgia and arthralgia that worsens with episodes
31
What is orofacial dystonia?
involves involuntary, excessive sustained muscle contractions
32
What is diagnosis for orofacial dystonia?
history of dystonia in orofacial region with hx and exam of positive for myalgi and arthralgia that worsens with episodes
33
What is disc displacement with reduction (DDwR)?
disc is anterior position to condylar head when mouth is closed and when opening, the disc reduces = clicking/popping noise
34
What is dx for DDwR?
history of TMJ noises with jaw function OR any noise during exam Has one of the following: - Noises during opening and closing detected with palpation - Noises detected with palpation during opening or closing AND during lateral and protrusive movement
35
What is disc displacement with intermitten locking (DDwRwIL)?
disc is anterior in closed mouth position and then reduces with opening; if disc does not reduce = intermittent limited opening = need a maneuver to unlock TMJ - Will answer yes to Q9 which is having jaw lock when trying to open and not being able to open all the way for a moment
36
How do you diagnose DDwRwIL?
hx of TMJ noises with jaw movement OR noises during the exam AND jaw locks with limited mouth opening - Noises during opening AND closing OR - Noises with during opening or closing and during lateral and protrusive movements
37
What is disc displacement without reduction with limited opening (DDwoRwLO)?
Disc is anterior in closed mouth and does NOT reduced when opening; persistent limited mouth opening that will not reduced with maneuver, aka “closed lock: - ROM is limited to <40 mm - Disc is anterior, medial, or lateral to condyle and does NOT reduce = limited ROM and will deflect to affected side
38
What is dx for DDwoRwLO?
jaw locks so mouth cannot open all the way AND limitation interferes with ability to eat - MAO is < 40 mm
39
What is disc displacement without reduction without limited opening (DDwoRwoLO)?
anterior position of disc in closed mouth and does not reduce when opened but does NOT have limited opening (> 40 mm)
40
How do you diagnose DDwoRwoLO?
Locked jaw and interfere with ability to eat
41
How do you diagnose a pt with degenerative joint disease?
history of noises (crepitus/sand) with movement or during exam - Crepitus is detected with palpation during opening/closing, lateral, or protrusive movements
42
What is subluxation?
disc-condyle complex become anteriorly positioned to articular eminence when opening and is unable to return to normal closed mouth without maneuver; when can reduce itself = sub
43
How do you diagnose a pt with subluxation?
jaw locking in wide mouth open position and inability to close from wide-mouth without maneuver
44
What is luxation?
where jaw locks in open position and need clinician to reduce it back = “open lock” - requires CBCT or MRI for confirmation and need to see condyle anterior to eminence when patient tries to close
45
What is dx for arthralgia?
Joint pain/ tenderness in TMJ affected by movement, pain on palpation, NO noises, no degenerative changes
46
What is dx for arthritis?
Arthralgia + swelling, inflammation redness, and elevated temp = structural changes = definitive diagnosis
Orofacial Pain
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