What is the typical clinical finding in TMD patients with myofascial pain?

• A. Tenderness of the masticatory muscles (masseter, temporalis), increased muscle tone, and referred pain patterns.
• B. Joint crepitus with normal muscle tone.
• C. Bone fracture.
• D. Paresthesia of the tongue.

Answer: (B)

In myofascial TMD, the standout finding is involvement of the jaw muscles themselves. The typical picture is tenderness in the masticatory muscles (like the masseter and temporalis), often with increased muscle tone as the patient guards or relies on those muscles, and pain that can be felt or referred beyond the site of palpation. This reflects trigger points within the muscles that radiate pain to nearby regions such as the jaw, temple, and teeth.

Joint crepitus with normal muscle tone points more toward articular problems of the TMJ, such as disc displacement or degenerative changes, rather than a primary myofascial muscle issue. Fracture or nerve-related symptoms like tongue paresthesia are not characteristic of myofascial pain either.

So the hallmark for myofascial TMD is muscle tenderness with possible increased tone and referred pain patterns, not joint crepitus or other non-muscular signs.