45 yrs old female came for chest pain but accidentally she tells history of inability to open mouth since birth nd her lips found to b edematous. Can anyone sort out this diagnosis ?? Thank u

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Painless lock jaw other than Tetanus is congenital defect of muscle, skeleton and joints of mouth. This defect can cause nutritional deficiency and reflux oesophagitis. She looks to have shrunken cheek. Hyper pigmentation over the lip -- we may think about sun burn, Additions disease , Peutz jegar syndrome which are common. In this Additions disease is commonly associated with immune deficiency diseases like HIV , Type 1 DM etc. So Resp and heart conditions to be excluded. If you specify the site of chest pain it will further help in diagnosis.

Advice her OPG. (Orthopentogram)which shows Temperomandibular joint. Could be trauma to the TMJ. @ childhood which she is not giving in history

She spoke wit partially opened mouth but can't even able to view her palate

Doc is she having TMJ problem since birth? She appears kind of Bird facie due to partial ankylosis or arthritis..
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how did she tell her story when she can't open her mouth?

Your sudden reply made me laugh! Valid point though!
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please do an imaging of the bilateral tm joints to see whether its properly formed or not. Its presence since birth rules out tetanus. Also the tone of facial muscles needs to b evaluated. Once the possible pathology of local structures are

ruled out then rule out any autoimmune cause.
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Rule out psychiatric illness.,dislocation oF TM joint,epilepsy aswell

congenital defect in the joints and muscles of mouth.

Congenital defect in joints & muscles of mouth.

Bird face appearance.. Can be ankylosis of tmj

could be scleroderma
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Dr Amit iam a oral & Maxillofacial surgeon

u should take care of tat pt
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