Which combination of findings is typical of TMJ osteoarthritis on exam?

• A. Crepitus during movement, point tenderness over the TMJ, reduced ROM, jaw deviation on opening.
• B. No tenderness and normal ROM.
• C. Pain only in the jaw with no signs.
• D. Only muscle tenderness without joint signs.

Answer: (A)

TMJ osteoarthritis presents with changes inside the joint that produce both mechanical symptoms and local signs on exam. The joint surfaces wear and roughen, so you commonly hear or feel crepitus as the jaw moves. There is often point tenderness right over the TMJ from inflammation and degeneration of the structures there. Movement is typically limited, especially maximal opening, because osteophytes and cartilage loss restrict the joint space. When opening, the jaw may deviate toward the affected side, reflecting asymmetric stiffness or narrowing on that side. This combination of joint sounds, focal joint tenderness, reduced range of motion, and opening deviation fits TMJ osteoarthritis well. In contrast, no tenderness with normal ROM, pain confined to the jaw without signs, or isolated muscle tenderness without joint signs would favor non-arthritic or non-joint etiologies such as myofascial pain or referred pain.