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Condition/Disorder Synonyms


  • Temporomandibular joint dysfunction (TMJD)

  • Temporomandibular joint pain

  • Temporomandibular joint internal derangement

  • Temporomandibular joint dysfunction syndrome

  • Costen's syndrome


ICD-9-CM Codes


  • 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 non-reducing)

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

  • 524.69 Other specified temporomandibular joint disorders


ICD-10-CM Codes


  • 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


Preferred Practice Patterns1


Key Features




  • 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's syndrome.

  • Five stages of disk displacement


Essentials of Diagnosis


  • Dysfunction of the joint, muscle imbalances

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


General Considerations


  • The TMJ has two joints, allowing one to rotate and slide (translate).

  • Ligament laxity and disk desiccation need to be assessed.

  • Wear of the bone and cartilage can lead to popping, clicking and pain.




  • Women > men

  • Age range: 20 to 40 years of age


Clinical Findings


Signs and Symptoms


  • Can involve one or more of the TMJ components such as the muscles, nerves, tendons, ligaments, bones, and teeth

  • Deviation of the mandible with opening and closing

  • Malalignment of the teeth

  • Wearing of the teeth, flattening of the top of the teeth

  • Grinding

  • Hypertonicity of the pterygoids and masseter muscles

  • Ear pain, ache (otalgia) and ear swelling

  • Orofascial pain

  • Audible click/pop with opening and closing of the jaw

  • Reciprocal clip

  • Limited opening of the jaw

  • Inability to open/close jaw/locking

  • Crepitus

  • Swelling, heat, redness at the TMJ

  • Headaches/migraines

  • Tinnitus

  • Trigeminal nerve issues, Cranial nerve (CN) V


Functional Implications


  • Inability to bite/eat larger objects such as an apple

  • Headaches that limit function

  • Locking of the jaw


Possible Contributing Causes


  • Trauma

  • Whiplash

  • Blunt trauma, punch or hit to the face ...

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