Symptomatic osteoarthritis of the temporomandibular joint: report of a case.

A case of osteoarthritis in the TMJ which manifested clinical symptoms, radiographic changes, and the classic microscopic alterations has been presented. Whether the condition was a primary or secondary form of the disease could not be unequivocally ascertained, as the symptoms preceded the injection of a sclerosing solution and a mandibular fracture, both of which could be significant contributing factors to a trauma-induced secondary osteoarthritic change. Nevertherless, a lack of symptoms in other joints would tend to exclude a generalized (primary) form of osteoarthropathy. In this regard, symptoms referable to the TMJ (to the exclusion of other joints) are more consistent with findings of secondary osteoarthritic change. Whether osteoarthritic changes were discernible by radiography in the TMJ before the traumatic episodes recorded in the history is unknown. Indeed, a developmental anatomic anomaly could not be ruled out. Regardless of whether the changes were the result of primary degenerative disease or chronic trauma, the symptoms were adequately resolved by surgical intervention.