What does a normal joint palpation with focal muscle tenderness indicate?

• A. Pure intra-articular pathology.
• B. It suggests a myofascial pain component rather than pure intra-articular pathology.
• C. No pain
• D. Inflammation of the joint

Answer: (B)

When the joint itself feels normal on palpation but there is focal tenderness in the surrounding muscles, it points to a myofascial pain component rather than a primary joint problem. In TMD, muscles of mastication (like the masseter or temporalis) can develop taut bands or trigger points that produce localized tenderness and referred pain, while the joint remains non-tender and normal in appearance. Inflammation or pure intra-articular pathology would typically present with joint-specific signs (swelling, warmth, crepitus, or tenderness over the joint itself) rather than isolated muscle tenderness. So this pattern best fits myofascial (muscle-related) pain contributing to the symptoms.