Lee Evelyn, Shoenberger Jan, Wagner Jonathan
LAC+USC Medical Center, 1200 North State Street 1060H, Los Angeles, CA 90033, USA.
LAC+USC Medical Center, Keck School of Medicine of USC, Los Angeles, CA, USA.
Case Rep Emerg Med. 2015;2015:753260. doi: 10.1155/2015/753260. Epub 2015 Sep 7.
A 24-year-old male with a history of psychiatric disorder and no prior significant temporomandibular joint (TMJ) pathology presented to the emergency department for "lockjaw." Plain film X-rays of the mandible were read as unremarkable by an attending radiologist, leading to the initial diagnosis of medication-induced dystonic reaction. Following unsuccessful medical treatment a maxillofacial computed tomography (CT) was ordered. CT confirmed bilateral dislocation, illustrating the importance of clinical judgment, and limitations of certain radiographic images. The authors believe this case to be the first reported case in the medical literature of bilateral anterior TMJ dislocation with a false negative X-ray.
一名24岁男性，有精神病史，既往无明显颞下颌关节（TMJ）病变，因“牙关紧闭”就诊于急诊科。下颌骨的普通X线片经主治放射科医生读片后显示无异常，初步诊断为药物性肌张力障碍反应。药物治疗无效后，进行了颌面计算机断层扫描（CT）。CT证实双侧脱位，说明了临床判断的重要性以及某些影像学检查的局限性。作者认为此病例是医学文献中首例报道的双侧TMJ前脱位且X线检查为假阴性的病例。
