Event 3: Initial Assessment and Diagnosis

Christine's Initial Assessment

  • Myalgia of right masseter muscle
  • Myofascial pain associated with right anterior temporalis muscle
  • Tension-type headache
  • Parafunctional habit (e.g. grinding/clenching)
  • Anxiety with possible depression

Christine’s Pain Differential Diagnosis

Diagnosis (possible)

  • Temporomandibular joint disorder (TMD)

Diagnosis (unlikely)

  • TMJ Synovitis/Capsulitis: no evidence on clinical exam due to:
    • Lack of pain on palpation of the TMJs or pre-auricular areas bilaterally and
    • No evidence of TMJ or pre-auricular swelling observed bilaterally
  • TMJ Articular Disc Disorder: no evidence on clinical exam due to absence of TMJ noise (click/pop/crunch) audibly or on palpation
  • TMJ Arthritis: no evidence on x-ray
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