Bilateral temporomandibular joint dislocation

Case contributed by Derek Smith
Diagnosis certain

Presentation

Fall. Acutely dysarthric following this. Suspected posterior circulation stroke. CT head to rule out hemorrhage.

Patient Data

Age: 80 years
Gender: Male

No acute intracranial finding.

No hematoma, hyperdense vessel, or recent territorial infarct.

Established bilateral cerebellar, right basal ganglia, and right parietal infarcts, with moderate periventricular and deep white matter small vessel changes.

Mild generalized volume loss. No hydrocephalus.

Bilateral TMJ dislocation. No fracture. No soft tissue abnormality in imaged limits.

3D bone reconstruction demonstrating bilateral anterior TMJ dislocations, perched on the anterior aspect of the articular tubercles.

Case Discussion

An important reminder to check the edge of the film, and review bone structures on head imaging.

In the original fall, the patient had caught their chin with bruising, and this was sufficient in this case to dislocate both TMJs. Once recognized and relocated, the patient's speech returned to normal.

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