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Dr Stephen J Davies
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Examination: Joints

Examination: Muscles

Examination of the temporomandibular joint

Tenderness to palpation | Joint sounds | Range of motion

Joint sounds

There are 2 types of joint sound to look out for:

  • Clicks - single explosive noise
  • Crepitus - continuos 'grating' noise

Clicks

A joint click probably represents the sudden distraction of 2 wet surfaces, symptomatic of some kind of disc displacement. The diagnosis of a joint click, and therefore treatment, varies on whether the click is left, right or bilateral, painful or painless, consistent or intermittent. The timing of a click is also significant: a click heard later in the opening cycle may represent a greater degree of disc displacement.

Clicks may frequently be felt as well as heard, though they are not normally painful.

Crepitus

Crepitus is the continuous noise during movement of the joint, caused by the articulatory surfaces of the joint being worn. This occurs most commonly in patients with degenerative joint disease.

The joint sounds should be listened to with a stethoscope, preferably a stereo one, as the two sides can be more easily compared.


Listening to the TMJ