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A 56-year-old female presented for evaluation with chief complaints of right TMJ pain and limited mandibular opening. Her history was most notable for long-standing RA refractory to multiple medications. (a) Bilateral toe involvement requiring Hoffman procedure; (b) Bilateral wrist involvement; (c) CT of the face showed early unilateral right TMJ ankylosis, lateral pannus formation, and heterotopic bone formation. The left TMJ was completely normal.
