Which features suggest inflammatory arthropathy rather than pure myofascial TMD?

• A. Trigger points and local muscle tenderness
• B. Joint swelling, warmth, prolonged morning stiffness, systemic signs; radiographic findings of joint space narrowing
• C. Isolated toothache
• D. Muscle hypertrophy

Answer: (B)

Inflammatory arthropathy involves the joint itself, so signs of intra-articular inflammation distinguish it from pure myofascial TMD. Joint swelling and warmth reflect active synovitis, prolonged morning stiffness is typical of inflammatory processes, and systemic signs point to a systemic inflammatory state. Radiographic joint space narrowing indicates cartilage loss within the joint due to inflammatory damage. In contrast, pure myofascial TMD is driven by muscles, so you’d expect trigger points and focal muscle tenderness rather than joint effusion or warmth, and imaging would usually be normal unless secondary changes occur. Isolated toothache or muscle hypertrophy do not specifically indicate intra-articular inflammation.