pt has history of rheumatoid arthritis . Noticed left side of jaw is much smaller and a deformation of the left joint . Any ideas of this is from the RA ?

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any h/o Juvenile Idopathic Arthritis while childhood? Interesting case Dr.S.Negi.

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Juvenile idopathic arthritis

Ankylosis because of Rheumatoid Arthritis. radiopacity on the left side suggestive of ankylosis?

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Erosion of left TMJ because the patient chews from left side (local factor) plus rheumatoid arthritis (systemic factor). Please check if there is any history of trauma (accident or surgical extraction of 3rd molars)

Check for tmj pain, clicking sounds deviation of mandible, locked jaw. Also ask for history of clenching mouth (bruxism = less possibility since no attrition) (seizure due to epilepsy/ hyperthermia) (OCD=anxiety)
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If you don't see any visual Are palpable different on clinical examination then it's and art effect in opg If Req take one more opg are if in case of diff felt in clinic examination Cbct can tell more of info

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Any systemic disorder of bones that sets in when growth of bone is happening,growth will be affected. Similarly local disturbance can affect Either left or right jaw.

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Facial asymmetry due to ankylosis

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Condyle seems to be dislodged from the fossa and is on the articular eminence...isn't it ? ..hence the deviation...

Quite possible
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Ankylosis..

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To rule out RA repeat OPG

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