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In vivo Macrophage Imaging Using MR Targeted Contrast Agent for Longitudinal Evaluation of Septic Arthritis
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Septic Arthritis of the Temporomandibular Joint with Intracranial Extension: A Case Report

Natalie Turton1, David M McGoldrick1, Kieran Walker1

  • 1Department of Oral and Maxillofacial Surgery, Queen Elizabeth Hospital, Birmingham, B15 2GW UK.

Journal of Maxillofacial and Oral Surgery
|April 11, 2022
PubMed

Insights

Septic arthritis of the temporomandibular joint (TMJ) is a rare condition. This case highlights the importance of multidisciplinary care for diagnosing and managing this unusual infection, even with intracranial extension.

Area of Science:

  • Otorhinolaryngology
  • Infectious Diseases
  • Neurosurgery

Background:

  • Septic arthritis of the temporomandibular joint (TMJ) is infrequently documented.
  • Early diagnosis and intervention are crucial for favorable outcomes.

Observation:

  • An 18-year-old male presented with symptoms suggestive of TMJ dislocation.
  • Clinical presentation included left preauricular swelling, pain, trismus, malocclusion, and sepsis.
  • Blood cultures identified *Fusobacterium necrophorum*.

Findings:

  • Computed tomography (CT) confirmed left TMJ effusion and a temporal space collection.
  • Intracranial extension into the left middle cranial fossa was identified on subsequent imaging.
  • Needle arthrocentesis, drainage, and six weeks of antibiotics led to resolution.

Implications:

  • This case underscores the necessity of considering septic TMJ arthritis in patients with severe facial pain and systemic signs of infection.
  • Prompt, multidisciplinary collaboration involving neurosurgery and microbiology is vital for effective management.
  • Aggressive treatment can lead to successful resolution, even with complications like intracranial extension.
Keywords:
Extradural empyemaFusobacterium necrophorumSeptic arthritisTemporomandibular joint

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