Differential Diagnosis for Tenderness on Temporal Area
Single Most Likely Diagnosis
- Temporal Arteritis: This is a common condition, especially in older adults, where the temporal arteries become inflamed, leading to tenderness in the temporal area. The age of the patient and the presence of other symptoms like headache, jaw claudication, and visual disturbances can support this diagnosis.
Other Likely Diagnoses
- Tension Headache: Tension headaches are very common and can cause tenderness in the temporal area due to muscle tension. The presence of a band-like pressure around the forehead and the absence of other alarming symptoms can suggest this diagnosis.
- Migraine: Migraines can also cause tenderness in the temporal area, often accompanied by a severe, unilateral headache, nausea, vomiting, and sensitivity to light and sound.
- Temporal Mandibular Joint (TMJ) Disorder: Disorders of the TMJ can cause pain and tenderness in the temporal area, especially when chewing or opening the mouth wide. Clicking of the jaw and limited range of motion can support this diagnosis.
Do Not Miss Diagnoses
- Giant Cell Arteritis: Although this falls under the broader category of temporal arteritis, it's crucial to specifically identify it due to its potential to cause blindness if not promptly treated. Symptoms like visual loss, diplopia, and jaw claudication are red flags.
- Temporal Lobe Abscess: A rare but potentially life-threatening condition that can cause tenderness in the temporal area, along with symptoms like fever, seizures, and focal neurological deficits.
- Meningitis: Inflammation of the meninges can cause headache and tenderness in various areas of the head, including the temporal region, along with fever, stiff neck, and altered mental status.
Rare Diagnoses
- Trigeminal Neuralgia: A condition that affects the trigeminal nerve, causing intense pain in the face, which can sometimes be perceived in the temporal area. It's characterized by sudden, severe, shock-like or stabbing pain.
- Temporal Bone Fracture: A fracture in the temporal bone can cause tenderness in the temporal area, often resulting from trauma. Other symptoms might include hearing loss, vertigo, and facial paralysis.
- Eagle Syndrome: A condition caused by an elongated styloid process or calcified stylohyoid ligament, which can cause facial and temporal pain, often mimicking other conditions.