title: Osteoblastoma of the temporal articular tubercle misdiagnosed as a temporomandibular joint disorder.
abstract: The case of a 17-year-old female with a benign osteoblastoma in the temporomandibular joint (TMJ) is reported. The patient had a 2.5-year history of reduced mouth opening accompanied by tenderness and swelling in the left TMJ. Initial treatment included stabilization of the occlusion with a splint, jaw exercises, and analgesics. At first the patient's symptoms decreased, but they then increased 18 months later, prompting a cone beam computed tomography (CBCT) evaluation of the joint. The radiographic findings showed a somewhat ill-defined, radiolucent, expansile lesion containing small scattered calcifications located in the temporal articular tubercle. The lesion was removed under general anaesthesia and sent for histopathological examination. At the 12-month follow-up, the patient had normal TMJ function without clinical symptoms. CBCT examination showed a small recurrence of 3mm. Another 12 months later, CBCT showed a 1-mm increase in the recurrence. Her function was normal, with slight tenderness lateral to the left TMJ. The decision from a multidisciplinary meeting was further annual follow-up. The present case illustrates the importance of initial radiographic examination together with clinical examination in patients with TMJ dysfunction.
authors.affiliation: Department of Odontology, Umeå University, Umeå, Sweden.
authors.forename: J
authors.initials: J
authors.lastname: Emanuelsson
authors.affiliation: Ohio State University, College of Dentistry, Columbus, OH, USA.
authors.forename: C M
authors.initials: CM
authors.lastname: Allen
authors.affiliation: Department of Oral and Maxillofacial Radiology, Sundsvall Hospital, Sundsvall, Sweden.
authors.forename: K
authors.initials: K
authors.lastname: Rydin
authors.affiliation: Department of Odontology, Umeå University, Umeå, Sweden. Electronic address: mats.sjostrom@umu.se.
authors.forename: M
authors.initials: M
authors.lastname: Sjöström
mesh_terms: D000293:Adolescent; D001859:Bone Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery*; D054893:Cone-Beam Computed Tomography; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D018215:Osteoblastoma / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery*; D013704:Temporomandibular Joint / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery*; D013705:Temporomandibular Joint Disorders / Q000000981:diagnostic imaging
keywords: dentistry; osteoblastoma; temporomandibular disorders