Acute onset trismus in a 15-year-old. (2nd December 2019)

• Record Type: Journal Article
• Authors: Mohammed, Manal; Beech, Andrea; Farrier, Jeremy
• Is Part Of: Dental update. Volume 46:Number 11(2019)
• Page Start: 1075
• Page End: 1077
• Publication Date: 2019-12-02
• Subjects: Dentistry -- Periodicals; 617.6
• DOI: 10.12968/denu.2019.46.11.1075
• Languages: English
• ISSNs: 0305-5000

Abstract

Abstract : Trismus can be a common complaint encountered in general dental practice. A 15-year-old female presented to the Emergency Department with a history of acute onset and worsening trismus, pain and extra-oral swelling following placement of a restoration in the lower right first molar tooth. An initial diagnosis of trismus associated with either muscular spasm or a haematoma following an inferior alveolar nerve (IAN) block was assumed. The patient was reviewed the following week, the trismus and swelling having increased. An urgent MRI scan showed a large heterogeneous mass in the right masticator space. A biopsy under general anaesthetic diagnosed a rhabdomyosarcoma. The patient was referred to the oncology team for chemo/radiotherapy treatment. CPD/Clinical Relevance: Although 'common things occur commonly', it is important to remember that common symptoms and presentations can lead to more rare diagnoses. Prompt referral for specialist advice needs to be sought should first line management of trismus prove to be unsuccessful.