Jaw pain/swelling

Differential Diagnosis
In alphabetical order.


 * Behavioral disorders
 * Burkitt lymphoma
 * Dental or periodontal pathology
 * Fibromyalgia
 * Giant Cell Arteritis
 * Headache with radiation to the jaw
 * Herpes zoster or post-herpetic neuralgia
 * Metastases to mandible, maxilla or TMJ
 * Mucosal lesions
 * Neuralgias
 * Neuropathies
 * Paranasal sinus pathology
 * Primary neoplasms of the maxilla, mandible, or major salivary gland
 * Referred pain from cardiac, cervical spine, pulmonary or throat disease
 * Rheumatologic disease
 * Salivary gland pathology (inflammation, neoplasm, or ductal stone)
 * Systemic arthritis
 * Temporomandibular joint disorder (TMJ)

History and Symptoms

 * Onset
 * Character
 * Pattern of pain
 * Past medical history
 * Past surgical history
 * Complete review of systems
 * Associated symptoms

Physical Examination

 * Oral exam
 * Head exam
 * Ear, nose exam
 * Cardiac exam
 * Pulmonary exam
 * Lymphatic exam

Laboratory Findings

 * Appropriate lab studies for suspected diagnoses

X Ray

 * Sinus X-ray may be indicated

MRI and CT

 * CT and MRI may be required

Other Imaging Findings

 * Panorex films

Other Diagnostic Studies

 * Referral if necessary
 * Therapeutic trial of medications
 * Temporal artery biopsy
 * Biopsy of suspicious lesions

Treatment

 * Specialized treatment for dental or periodontal pathologies
 * Bite block
 * Cold/warm compresses
 * Avoid gum chewing
 * Avoid jaw clenching
 * Stress reduction
 * Treat underlying etiologies

Acute Pharmacotherapies

 * Intra-articular steroid / lidocaine injections
 * High dose steroids
 * Pain relievers
 * Migraine-specific therapy
 * Nonsteroidal anti-inflammatory drugs (NSAIDs)
 * Anticonvulsants