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CONDITION/DISORDER SYNONYMS

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  • Costen syndrome

  • Temporomandibular joint dysfunction (TMJD)

  • Temporomandibular joint dysfunction syndrome

  • Temporomandibular joint internal derangement

  • Temporomandibular joint pain

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ICD-9-CM CODES1

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  • 524.6 Temporomandibular joint disorders

  • 524.60 Temporomandibular joint disorders, unspecified

  • 524.61 Temporomandibular joint disorders, adhesions and ankylosis (bony or fibrous)

  • 524.62 Temporomandibular joint disorders, arthralgia of temporomandibular joint

  • 524.63 Temporomandibular joint disorders, articular disk disorder (reducing or nonreducing)

  • 524.64 Temporomandibular joint disorders, temporomandibular joint sounds on opening and/or closing the jaw

  • 524.69 Other specified temporomandibular joint disorders

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ICD-10-CM CODES2

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  • M26.60 Temporomandibular joint disorder, unspecified

  • M26.61 Adhesions and ankylosis of temporomandibular joint

  • M26.62 Arthralgia of temporomandibular joint

  • M26.63 Articular disk disorder of temporomandibular joint

  • M26.69 Other specified disorders of temporomandibular joint

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PREFERRED PRACTICE PATTERNS3

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  • 4D: Impaired Joint Mobility, Motor Function, Muscle Performance, and Range of Motion Associated with Connective Tissue Dysfunction

  • 4E: Impaired Joint Mobility, Motor Function, Muscle Performance, and Range of Motion Associated with Localized Inflammation

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PATIENT PRESENTATION

A 32-year-old female presents at the clinic with right lateral jaw pain. The patient states she thought she had an ear infection, but the family physician stated the ear was clear. She states she has been under a lot of stress. Her husband states she grinds her teeth at night. Patient has complaints of headaches and difficulty eating apples that are uncut. Upon opening of her jaw, it is noted that the mandible deviates to the left.

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FIGURE 111-1

This three-dimensional CT image reveals fractures of the mandibular angles bilaterally. (From Malone TR, Hazle C, Grey ML. Imaging in Rehabilitation. http://accessphysiotherapy.com. Copyright © The McGraw-Hill Companies, Inc. All rights reserved.)

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FIGURE 111-2

In this sagittal MRI of a 36-year-old female, the disk on the asymptomatic right is positioned normally in the fossa superior to the mandibular condyle. (From Malone TR, Hazle C, Grey ML. Imaging in Rehabilitation. http://accessphysiotherapy.com. Copyright © The McGraw-Hill Companies, Inc. All rights reserved.)

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KEY FEATURES

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Description
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  • Often referred to as TMJ (temporomandibular joint) which is the name of the joint, but does not describe any specific dysfunction

  • Syndrome is an umbrella term describing acute or chronic inflammation of the TMJ

  • Diagnosis covers an array or acute or chronic problems of the TMJ

  • Originally described by James B. Costen in 1934 and initially known as Costen syndrome

  • Five stages of disk displacement

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Essentials of Diagnosis
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  • Dysfunction of the joint, muscle imbalances4

  • Alignment problems between the temporal and mandible bones and the cervical spine

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General Considerations
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  • The TMJ has two joints, allowing one to rotate and ...

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