A 42-year-old woman attended the Maxillofacial Surgery Department of the Marqués de Valdecilla University Hospital in Santander (Spain) for several days of discomfort in the right temporomandibular joint (TMJ).
The patient reported clicking of the right TMJ for several years with no other accompanying symptoms.
Physical examination revealed no dento-skeletal abnormalities. She presented a maximum painless oral opening (MAO) of 45 mm, reciprocal TMJ clicking (at the beginning of opening and at the end of closing), posterior deviation and protrusion greater than 10 mm. Selective pain on palpation of the right masseter and pterygoids.
A panoramic radiograph was taken showing left condylar duplication.

Magnetic resonance imaging (MRI) of both TMJ showed the presence of anterior displacement of the disc, which was reduced to the opening in the right TMJ. In the left TMJ, the morphology of the condyle was striking: anteroposterior bifidity and the presence of a grade II joint effusion. To complete the imaging study, a computerised tomography (CT) scan of both TMJs was requested, which confirmed the existence of an anteroposterior bifid left condyle with no evidence of degenerative changes.

The patient was treated conservatively with an unloading splint, muscle relaxants, anti-inflammatory drugs, local heat and a soft diet. With this treatment she improved clinically and is currently followed up in routine check-ups in our outpatient department.