Jaw pain/swelling

Jaw pain/swelling
Burkitt's lymphoma. Image courtesy of Professor Peter Anderson DVM PhD and published with permission © PEIR, University of Alabama at Birmingham, Department of Pathology

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Differential Diagnosis

In alphabetical order.

• Behavioral disorders
• Burkitt lymphoma
• Dental or periodontal pathology
• Fibromyalgia
• Giant Cell Arteritis
• Headache with radiation to the jaw
• Herpes zoster or post-herpetic neuralgia
• Metastases to mandible, maxilla or TMJ
• Mucosal lesions
• Neuralgias
• Neuropathies
• Paranasal sinus pathology
• Primary neoplasms of the maxilla, mandible, or major salivary gland
• Referred pain from cardiac, cervical spine, pulmonary or throat disease
• Rheumatologic disease
• Salivary gland pathology (inflammation, neoplasm, or ductal stone)
• Systemic arthritis
• Temporomandibular joint disorder (TMJ)

History and Symptoms

• Onset
• Character
• Pattern of pain
• Past medical history
• Past surgical history
• Complete review of systems
• Associated symptoms

Physical Examination

• Oral exam
• Head exam
• Ear, nose exam
• Cardiac exam
• Pulmonary exam
• Lymphatic exam

Laboratory Findings

• Appropriate lab studies for suspected diagnoses

X Ray

• Sinus X-ray may be indicated

MRI and CT

• CT and MRI may be required

Other Imaging Findings

• Panorex films

Other Diagnostic Studies

• Referral if necessary
• Therapeutic trial of medications
• Temporal artery biopsy
• Biopsy of suspicious lesions

Treatment

• Specialized treatment for dental or periodontal pathologies
• Bite block
• Cold/warm compresses
• Avoid gum chewing
• Avoid jaw clenching
• Stress reduction
• Treat underlying etiologies

Pharmacotherapy

Acute Pharmacotherapies

• Intra-articular steroid / lidocaine injections
• High dose steroids
• Pain relievers
• Migraine-specific therapy
• Nonsteroidal anti-inflammatory drugs (NSAIDs)
• Anticonvulsants