Anterior Disc Displacement in a Young Patient With Stage II Osteoarthritis: Diagnostic and Therapeutic Approach. A...

Anterior disc displacement without reduction can cause acute functional limitations and may coexist with inflammatory and early degenerative changes in young patients. We report a 22-year-old woman with right preauricular pain, a closed lock, and a maximum unassisted interincisal opening of 19 mm. Cone-beam computed tomography and magnetic resonance imaging confirmed Stage II osteoarthritis of the right temporomandibular joint, right anterior disc displacement without reduction with limited opening, left anterior disc displacement with reduction, and bilateral joint effusion consistent with synovitis. Hormonal testing showed values discordant with the expected follicular-phase ranges after recent discontinuation of injectable contraception; this finding was interpreted as a potential modulatory factor rather than evidence of causation. Management included bilateral temporomandibular joint arthrocentesis, intra-articular administration of betamethasone and sodium hyaluronate, a stabilization splint, pharmacological therapy, physical therapy, and behavioral modification. Pain decreased markedly within the first week. At the 3-month follow-up, maximum unassisted mouth opening was 42 mm, with a straight opening path, pain-free function, and resolution of the right masseter spasm. This case highlights the value of early imaging-based diagnosis and individualized multimodal management in young patients with concomitant mechanical, inflammatory, and early degenerative temporomandibular joint changes.