Dense Bone Islands and Osteomas Suggest Familial Adenomatous Polyposis on TMJ Evaluation

A 17-year-old male was referred for TMJ evaluation with jaw pain, clicking, and locking. The radiologist identified numerous dense bone islands in both jaws bilaterally, more prominent in the mandible, along with two small osteomas in the right ethmoid air cells. The radiologist noted that the presence of multiple dense bone islands and osteomas strongly suggests Familial Adenomatous Polyposis syndrome, of which Gardner syndrome is a subtype. The referring clinician was advised to correlate with family history of colonic polyps, as these typically develop in the late 30s and carry a risk of malignant transformation over time. Referral to the patient's primary care provider for further diagnostic evaluation was recommended.