Case

A 40 year old patient is admitted into your care after having taken several blows to the head and face during a fist fight. Their chin is slightly offset to the left and there is a hard protuberance in front of their right ear. The patient is unable to close their mouth and is experiencing excruciating pain.  

Question 1/2 - What do you think has occurred?

Click on your selected option(s) below  (correct = 1, over-thinking = 2+)

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Incorrect. Tumors are slowly forming such that they are not going to develop acutely as in this case.  

Correct! The presence of the lateral offset to the mandible and the protuberance in front of the right ear suggests that the head of the mandible on the right has dislocated from the mandibular fossa of the skull. 

In this case you would also need to assess if there is a fracture to the mandible as a fracture vs. dislocation have different treatment pathways.

Incorrect. While a hematoma can form a bulge, an acute hematoma is unlikely to palpable as a hard protuberance.

Incorrect. While an infection forming an abscess can be quite firm to touch, these take some time to form and are typically associated with indications of infection (elevated temperature, redness, etc.).