Lader E
J Prosthet Dent. 1990 Jan;63(1):82-5. doi: 10.1016/0022-3913(90)90272-e.
Craniomandibular disorders cause many pleomorphic and seemingly unrelated clinical manifestations that mimic other more serious medical problems and thus can present physicians and dentists with a challenge that invites misdiagnosis and improper treatment planning. Conversely, misdiagnosis and ineffective treatment planning are facilitated when serious medical problems manifest a range of signs and symptoms that are clinically similar to temporomandibular joint muscle dysfunction. At times, the patient's response to therapy may be the best method of corroborating a diagnosis, as illustrated in this report of a patient with Lyme disease that was misdiagnosed as a temporomandibular joint disorder. Lyme disease has already reached epidemic proportions in several parts of the United States and its geographic distribution is spreading. Because Lyme disease is a life-threatening illness whose clinical manifestations can mimic temporomandibular joint/myofascial pain-dysfunction, it is the responsibility of every dentist who treats craniomandibular disorders to become familiar with the clinical presentations of Lyme disease and more proficient in its differential diagnosis.
颅下颌疾病会引发多种多样且看似不相关的临床表现，这些表现会模仿其他更严重的医学问题，因此可能给内科医生和牙医带来挑战，容易导致误诊和不恰当的治疗方案制定。相反，当严重的医学问题表现出一系列临床上与颞下颌关节肌肉功能障碍相似的体征和症状时，就容易出现误诊和无效的治疗方案制定。有时，患者对治疗的反应可能是确证诊断的最佳方法，本报告中一名莱姆病患者被误诊为颞下颌关节疾病的案例就说明了这一点。莱姆病在美国的几个地区已经达到流行程度，其地理分布正在扩大。由于莱姆病是一种危及生命的疾病，其临床表现可能模仿颞下颌关节/肌筋膜疼痛功能障碍，因此，每一位治疗颅下颌疾病的牙医都有责任熟悉莱姆病的临床表现，并更熟练地进行鉴别诊断。
