TMJ (Jaw)
TMJ Capsulitis/Synovitis
턱관절 활막염·관절낭염
Inflammation of joint capsule/synovium causing local pain and swelling
- How common
- Common (frequently seen with TMD)
- Typical age
- Ages 20–50
What is it?
Trauma, overuse, bruxism, or arthritis inflames the capsule and synovium, producing effusion and local pain.
Commonly affected: Capsule and synovium (uni/bilateral)
How it develops
- Triggering FactorTrauma, overuse, bruxism, systemic inflammation
- Synovial InflammationVasodilation and inflammatory infiltrate
- Joint EffusionIncreased synovial fluid raises intra-articular pressure
- Pain/Occlusal ChangeJoint tenderness, acute malocclusion
Symptoms
- Joint point tendernessSevere lateral pole tenderness
- Chewing painWorse with biting and chewing
- Local swelling/warmthPreauricular swelling and warmth
- Acute malocclusionPosterior open bite from effusion
- Mild opening limitationPain-limited opening
How it is examined
- Lateral pole tendernessPoint tenderness over lateral pole
- Joint loading testBite on cotton roll contralaterally — reproduces pain
- Local warmth/swellingWarmth and swelling on palpation
- Occlusal checkPossible posterior open bite from effusion
Imaging
Panoramic usually normal; excludes fracture after trauma.
- Usually normal
- Possible widened joint space (effusion)
- Excludes fracture
MRI sensitive for inflammation, effusion, capsular thickening.
- Joint effusion (T2 hyperintense)
- Capsular thickening/enhancement
- Periarticular edema possible
Non-surgical care
- Joint rest/soft dietMinimize chewing load
- NSAIDs/iceControls acute inflammation/swelling
- Stabilization splintReduces joint loading
- Intra-articular steroidImage-guided injection for refractory cases
Conservative options are generally tried first. Medications listed here can have side effects — discuss them with your prescriber.
When surgery is considered
Surgery rare — address underlying disc/arthritic pathology
Procedures that may be discussed
- Arthroscopy with lavage (highly selective)
Outlook
Most resolve in 2–4 weeks with conservative care; treat underlying cause.