Temporomandibular Joint Pain: An Unusual Initial Manifestation of Rheumatoid Arthritis

We present a 39-year old housewife with temporomandibular joint pain of more than a month duration prior to the development of symmetrical polyarthritis of the small joints of the hands, as an unusual first manifestation of rheumatoid arthritis. 

A raised acute phase reactant such as ESR is a very helpful indicator of an underlying inflammatory condition, hence the need for early referral to the Rheumatologist.