The results of the present study showed that the most prevalent symptoms and signs of TMJ disorders in the subjects were joint sounds (crepitus
) (31%), pain in masticatory muscles (10%), jaw pain during food mastication (24%) and pain at mouth opening (14%).
Additionally, it is imperative an exhaustive clinical assessment: mandibular range of motion evaluation, temporomandibular joint palpation including ligaments and capsule structures, masticatory musculature (temporalis and masseter) pain under pressure, load testing, sound detection (clicking, crepitus
, and hard-tissue grating); this process should be complemented with diverse auxiliary imaging (e.g., panoramic X-ray, panoramic TMJ images, cone beam computed tomography, and magnetic resonance imaging) .
The clinical presentation of subcutaneous emphysema, pneumomediastinum, and pneumopericardium is chest pain, dyspnea, dysphagia, chest and back pain, cyanosis, severe swelling, Hamman's sign (crunching-rasping sound like crepitus
synchronous with systole), and crepitus
on palpation .
This diagnosis should be considered in patient experiencing exquisite pain with a systemic toxicity, extensive cellulitis, crepitus
, and/or hyponatremia [20, 21].
"For a long time, doctors have told patients not to worry about crepitus
if it doesn't hurt," says Grace Lo, an assistant professor at the Baylor College of Medicine.
Clinical examination showed limb abduction with internal rotation of the knee, mild pain, crepitus
, limited range of motion during left hip manipulation, and a lack of palpable symmetry on the left side between the ischial tuberosity and the greater trochanter.
No area of ecchymosed, crepitus
or pain on palpation was observed, which removed the suspicion of underlying fractures.
Doctors have a term for those joint noises: crepitus
. Patients commonly complain of it, said Dr.
Snapping scapula is a condition first described by Boinet in 1867.5 Milch et al.6, had defined two distinct forms of scapulothorcic crepitus
related to snapping scapula, the osseous form which is related to an bony pathology of the superomedial angle of the scapula such as an osteochondroma and the soft tissue form which is associated to inflammation of the bursa present around the superomedial angle of the scapula.
Mild swelling of the left carpus was noted, although no crepitus
or joint laxity was palpable.
Physical examination revealed decreased breath sounds of his left lower lung fields and exquisite tenderness to palpation of his left anterior chest wall with no crepitus
. This area was mildly indurated.
Physical exam revealed chest crepitus
and X-ray showed subcutaneous emphysema with pneumomediastinum, which was thought to be secondary to esophageal microperforations.