Author: Ravi Tota Maharaj, Faisal Faruqi / Editor: Sarah Edwards / Codes: MaP3, MaP4, SLO4 / Published: 18/08/2025
A 20-year-old male presents to the Emergency Department (ED) following an assault by multiple unknown assailants. He arrives approximately 30 minutes after the incident, is initially confused and vomiting (likely due to alcohol intake), but is now fully alert. His main complaint is localized left-sided jaw pain. His relative states there are no further episodes of loss of consciousness or vomiting. The patient denies any difficulty chewing.
On examination, there is no overt facial deformity or obvious dental injury. He speaks clearly and demonstrates normal mouth opening without trismus. A non-contrast CT head is performed to exclude intracranial injury and returns normal. Because his symptoms are nonspecific, no dedicated mandibular imaging is obtained at this time. He is discharged with advice.
He re-presents days later with worsening jaw pain and difficulty achieving a normal bite. A subsequent orthopantomogram (OPG) reveals a mandibular fracture that was missed on the initial attendance.
3 responses
I tend to x-ray patient with fascial assaults and head injury. In 89% of my trauma cases, I found mandibular fractures. Good one and thanks!
Great Revision
Should have specified what type of imaging…