A patient reports jaw pain and clicking when chewing, with symptoms worsening during stress. Most likely diagnosis?

• A. TMD with disc displacement
• B. Myofascial pain syndrome
• C. TMJ osteoarthritis
• D. Discitis

Answer: (A)

The key idea here is recognizing a typical pattern of temporomandibular joint (TMJ) disc displacement with reduction. When the articular disc sits anterior to the condyle and then snaps back into place as the mouth opens, you often hear a click or pop, especially during chewing. Pain with chewing is common because the joint is being loaded and surrounding muscles may tense up in response, and stress can amplify that muscle tension and parafunctional activities like clenching or grinding, worsening symptoms.

This makes disc displacement with reduction the best fit for jaw pain plus a clicking sound that worsens with stress. By contrast, myofascial pain syndrome would mostly involve regional muscle tenderness and painful trigger points without a characteristic joint click. TMJ osteoarthritis could cause joint pain and some sounds but typically presents with crepitus, limited movement, and degenerative changes, often in older individuals. Discitis would present with severe, often systemic signs of infection such as fever and widespread bone or joint pain, not a mechanical clicking pattern linked to chewing.