TMJ Differential Diagnosis — ORE Part 1 MCQ

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

ModerateOral MedicineTMJ Differential DiagnosisORE Part 1

A patient attends with pain and dysfunction of the temporomandibular joints. They also report recurrent episodes of spinning vertigo, tinnitus and fluctuating hearing loss. Which non-temporomandibular diagnosis should be considered and referred for medical assessment?

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

Reveal the answer and explanation

Correct answer: A — Ménière's disease

Explanation lettering: E = shown as B · D = shown as C · C = shown as D · B = shown as E

A is correct. Recurrent vertigo with tinnitus and fluctuating hearing loss is a characteristic otological symptom complex of Ménière's disease, an inner-ear disorder affecting hearing and balance. These symptoms should not simply be attributed to coexisting temporomandibular symptoms; the patient requires medical assessment, with specialist investigation if Ménière's disease is suspected. Myofascial pain dysfunction, disc displacement with reduction and TMJ osteoarthritis are temporomandibular disorders, while sleep bruxism is a parafunctional activity that may contribute to TMD. They may coexist with ear-related complaints but do not account for the distinctive episodic vestibulo-auditory pattern in the stem.

Reference: NHS. Ménière's disease. Last reviewed 25 April 2023. https://www.nhs.uk/conditions/menieres-disease/?src=conditionswidget