JAW PAIN

JAW PAIN: Excerpt from Algorithmic Diagnosis of Symptoms and Signs

Ask the Following Questions:

1. Are there abnormalities on examination of the teeth or gums? A thorough examination of the teeth and gums may disclose dental caries, gingivitis, oral tumors, or alveolar abscess.
2. Is the pain intermittent? Intermittent pain should suggest a trigeminal neuralgia or glossopharyngeal neuralgia.
3. Is there a rash? The presence of a rash would suggest herpes zoster. Be sure to examine the eardrum for Ramsay Hunt's syndrome.

DIAGNOSTIC WORKUP

Routine diagnostic studies include a CBC, sedimentation rate, chemistry panel, arthritis panel, and an x-ray of the teeth and jaw. X-ray of the sinuses may be helpful. At this point referral to a dentist or oral surgeon should be made if there is still diagnostic difficulty. He may order an MRI of the temporomandibular joint, which is the procedure of choice in evaluating this joint. If all tests are negative or equivocal, perhaps a psychiatric referral is in order.

Book Source Details

• Book Title: Algorithmic Diagnosis of Symptoms and Signs
• Author(s): R. Douglas Collins
• Year of Publication: 2003
• Copyright Details: Algorithmic Diagnosis of Symptoms and Signs, Copyright © 2003 Lippincott Williams & Wilkins.

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Copyright notice for book excerpts: Copyright © 2008 Lippincott Williams & Wilkins. All rights reserved.

More About This Book: Title: Algorithmic Diagnosis of Symptoms and Signs Authors: R. Douglas Collins Publisher: Lippincott Williams & Wilkins Copyright: 2003 ISBN: 0-7817-3805-9

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