Initial clicking of TMJ is a sign of:

 # Initial clicking of TMJ is a sign of:
A. Retruded condyle
B. Unevenness of condylar surfaces
C. Incoordination between condylar surfaces and disc
D. Condyle too far anterior in relation to disc

The correct answer is A. Retruded condyle.

Early stages of disc displacement are characterised by clicking. Clicking can be heard while opening the mouth, while closing the mouth, or both. An opening click signifies recapture of the displaced disc between the articulating joint surfaces. A closing click occurs just prior to tooth contact and is not as loud as the opening click. When the disc becomes non-reducible, i.e. there is no recapture of the disc while opening the mouth, the clicking reduces in intensity or vanishes.

In the early stages (disc displacement with reduction), patients have been described as having increased range of anterior condylar translation. As the stage of disc displacement without reduction ensues, the patient encounters reduced mouth opening and even locked closed in some cases.

Ref: Mehndiratta A, Kumar J, Manchanda A, et al. Painful clicking jaw: a pictorial review of internal derangement of the temporomandibular joint. Pol J Radiol. 2019;84:e598-e615. Published 2019 Dec 23. doi:10.5114/pjr.2019.92287

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