[Clinical examination of the temporomandibular joint].

Pain in the TMJ area usually has a local cause and is seldom referred to any distance. The patient should also be asked about the influence of chewing, yawning, swallowing or talking. If pain is present on one of these, a disorder of the TMJ is most likely. Some disorders of the cervical spine (see Section 2) and the parotid gland may exceptionally also provoke pain on swallowing. A clear description of the type of pain should always be sought. A sharp severe pain tends to suggest an arthrogenic problem, a diffuse ache of less intensity points more to a muscular disorder. A painful click may be the consequence of subluxation of the intra-articular meniscus. Pain coming on spontaneously and progressively increasing over some weeks is often the result of arthritis. Continuous dull pain felt in the area of the masticatory muscles and usually worse at the end of the day may indicate myalgia.