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Septic arthritis of temporomandibular joint
N S Azmi1, N Mohamad2, N A Razali3
1Institut Kanser Negara, Department of Radiology, Wilayah Persekutuan Putrajaya, Malaysia.
Abstract:
Septic arthritis (SA) occurrence for temporomandibular joint (TMJ) is rare. Pain, fever, swelling or loss of TMJ function are the typical presentation. The more common diagnosis for these presentations is internal derangement, osteoarthritis and rheumatoid arthritis. Therefore, TMJ septic arthritis is a challenging diagnosis and at risk of delayed diagnosis. We present a case of TMJ septic arthritis in a 46 year old Malay female with underlying hypertension and hypercholestrolemia, which was diagnosed as internal derangement in the initial presentation. The initial radiograph was normal. Arthrocentesis procedure had temporarily relieved the symptoms before progressive facial swelling developed after a week. Contrast enhanced computed tomography (CECT) brain revealed left TMJ abscess formation with left condylar erosion. Patient subsequently improved after wound debridement, left condylectomy and antimicrobial therapy.
Insights
Septic arthritis of the temporomandibular joint (TMJ) is rare and often misdiagnosed. Prompt diagnosis and treatment, including surgery and antibiotics, are crucial for recovery.
Area of Science:
- Medical Case Study
- Infectious Disease
- Rheumatology
Background:
- Septic arthritis (SA) of the temporomandibular joint (TMJ) is uncommon.
- Typical symptoms like pain and swelling often mimic more common TMJ disorders.
Observation:
- A 46-year-old female with hypertension and hypercholesterolemia presented with TMJ symptoms initially diagnosed as internal derangement.
- Facial swelling progressed despite initial arthrocentesis, indicating a deeper issue.
Findings:
- Contrast-enhanced computed tomography (CECT) revealed a left TMJ abscess and condylar erosion.
- The patient was successfully treated with wound debridement, left condylectomy, and antimicrobial therapy.
Implications:
- Highlights the diagnostic challenges of TMJ septic arthritis.
- Emphasizes the importance of advanced imaging and prompt surgical intervention for effective management.
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