TMJ Dysfunction — ORE Part 1 MCQ

Instant feedback + full explanation. One question, done properly.

EasyOral MedicineTMJ DysfunctionORE Part 1

A 60-year-old woman presents with bilateral clicking of the temporomandibular joints and limited mouth opening. She has no pain. The clicks occur during both opening and closing. What is the most likely diagnosis?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: C — Anterior disc displacement with reduction

Anterior disc displacement with reduction (DDwR) is characterised by bilateral or unilateral TMJ clicking during both opening and closing, with preserved jaw opening and typically no pain. The disc is anteriorly displaced but reduces during mouth opening, producing the pathognomonic clicking. Disc displacement without reduction presents with pain and severely restricted opening ('closed lock'), excluding option B. Osteoarthritis produces crepitus (grinding), not clicking, and is associated with degenerative disc morphology and pain. Myofascial pain dysfunction affects masticatory muscles, not the joint, and does not produce mechanical clicking. Rheumatoid arthritis presents with pain, swelling, and systemic signs absent in this case. The constellation of bilateral painless clicking on both opening and closing in a 60-year-old woman with limited but preserved interincisal distance is the classic presentation of DDwR.

Reference: Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) and Magnetic resonance imaging evaluation of TMJ disc deformities. Pubmed 11474436 (2001); endorsed in UK NICE dental guidelines and RCS England Management of Painful TMD guidance. https://pubmed.ncbi.nlm.nih.gov/9505054/