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.

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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Congenital defect in joints & muscles of mouth.

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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Please rule out RA...

Rule out psychiatric illness.,dislocation oF TM joint,epilepsy aswell

Her ecg s normal and it costochondritis

TMJ anklyosis, CBCT essential

congenital defect in the joints and muscles of mouth.

Congenital defect in the joints and muscles of mouth
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