From the Guidelines
Temporomandibular joint (TMJ) effusion symptoms typically include pain and tenderness in the jaw area, limited jaw movement, clicking or popping sounds when opening or closing the mouth, facial swelling near the joint, and difficulty chewing, as well as headaches, earaches, or neck pain, according to the most recent guidelines 1.
Symptoms of TMJ Effusion
The symptoms of TMJ effusion can be quite debilitating and may significantly impact a patient's quality of life. Some common symptoms include:
- Pain and tenderness in the jaw area
- Limited jaw movement
- Clicking or popping sounds when opening or closing the mouth
- Facial swelling near the joint
- Difficulty chewing
- Headaches
- Earaches
- Neck pain These symptoms can be caused by excess fluid accumulation in the joint space due to inflammation or injury, as noted in the guidelines for management of temporomandibular disorders (TMD) 1.
Treatment Approaches
Treatment for TMJ effusion usually begins with conservative approaches, such as:
- Soft diet
- Avoiding extreme jaw movements
- Applying ice packs for 10-15 minutes several times daily
- Taking non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (400-800mg three times daily) or naproxen (500mg twice daily) for pain and inflammation Physical therapy exercises to strengthen jaw muscles and improve mobility may also be helpful, along with using a nightguard if teeth grinding is contributing to symptoms, as recommended by recent guidelines 1. For severe cases, a healthcare provider might recommend corticosteroid injections into the joint or arthrocentesis (joint fluid removal), with surgery considered only after non-response to conservative therapy 1.
From the Research
Symptoms of Temporomandibular Joint (TMJ) Effusion
The symptoms of TMJ effusion can be identified through various studies, including:
- Pain in the TMJ area, as reported in a case of inflammatory joint pain and dysfunction treated with bilateral TMJ full reconstruction with alloplastic prosthesis stock 2
- Limitation of mouth opening, which can be associated with joint disc displacement without reduction 2, 3
- Clinical signs of joint disc displacement without reduction, as seen in a patient with constant pain in TMJ bilaterally 2
- Periauricular swelling, erythema, fever, myalgia's, and generalized joint pain, as reported in a case of septic arthritis of the TMJ 4
- Decreased mouth opening, as commonly seen in patients with TMJ arthritis 5
- Gritty sound produced during chewing moments, as reported in patients with TMJ arthritis 5
- Clicking sounds, as relieved in majority of the patients treated with local infiltration of triamcinolone acetonide and hyaluronic acid 5
- Discomfort on lateral and medial movement, as relieved in some patients treated with local infiltration of triamcinolone acetonide and hyaluronic acid 5
Diagnostic Approaches
Diagnostic approaches for TMJ effusion include:
- Magnetic resonance imaging (MRI), which can show effusion of the joint space, as seen in a case of septic arthritis of the TMJ 4
- Computed tomography (CT) scan, although it may not show joint effusion, as reported in a case of septic arthritis of the TMJ 4
- Arthrocentesis, which can be performed to drain the effusion and submit the synovial fluid for gram stain, culture, and sensitivity, as seen in a case of septic arthritis of the TMJ 4
Therapeutic Approaches
Therapeutic approaches for TMJ effusion include:
- Alloplastic replacement of TMJ, which can be considered as an alternative therapy to improve the quality of life of patients showing signs and symptoms of TMD, such as reduction of maximum mouth opening and pain 2
- Local infiltration of triamcinolone acetonide and hyaluronic acid, which can relieve symptoms like pain and clicking sounds in majority of the patients 5
- Intra-articular corticosteroids, which can be used to treat internal disorders of the TMJ, although the effectiveness of different corticosteroids needs to be compared 6