case of tmj pathology+cervical pathology x-ray attached..

[spandanphysio]

hello friends kindly add u r suggestions regarding this case. Patient is 36/male having pain on the right side of the neck and at the atlanto occipital junction. Pain is countinous in nature like a soreness. Also having light swelling on SNCM muscle.

Neck movts. r free and pain less.

Kindly ask details u want...

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[msk101]

hi there,
We need a bit more information if you can...
Have you done any Cx palpation - compare facet joints either side, centrally, lateral glides, in rotation positions either side? did your neck movement assessments include distinction between upper and lower cervical flexion and chin tuck?
does your patient report any changes in symptoms with actions of chewing etc? ie. specific aggravation activities and then also any thing that makes it feel better (easing factors)? what is the 24 hour pattern? has there been any other significant medical/dental history? how long has this pain been persistent... insidious or sudden onset? what is the patient's posture like?

more information and a thorough subjective and objective may lead you to certain things to examine more closely to localise this pain, or highlight any "red flags" which you need to get seen to.

hope that helps.
msk101

[vasanthigerald]

seems to be muscle pathology considering his age. i think occupational history and other personal history might help

[spandanphysio]

hello friends thanx for u r kind rply.the pt is computer operator so he has to sit on pc for atleast 10 hrs a day.right side rotation and side flexion r painful.no specific pain pattern he discribes as a continous pain.his upper cervical spine moves well with all movements.lower 1 has some restrictions in rotation.previously it was dought for dental problem but is not like that.posture is like forward head as seen in x-ray also...