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Case Reports
. 2015 Oct;7(10):480-2.
doi: 10.4103/1947-2714.168678.

Septic Arthritis in the Temporomandibular Joint

Hassan Mahdi Al-Khalisy  1 , Ivan Nikiforov  1 , Qurat Mansoora  1 , John Goldman  1 , Pramil Cheriyath  1
Affiliations
Case Reports

Septic Arthritis in the Temporomandibular Joint

Hassan Mahdi Al-Khalisy et al. N Am J Med Sci. 2015 Oct.

Abstract

Septic arthritis of the temporomandibular joint (TMJ) is a rare event that has only been reported a few dozen times worldwide. This case is remarkable for septic arthritis of the TMJ joint in an otherwise healthy male.

Case report: A 24-year-old male presented to the emergency department with periauricular swelling, erythema, fever, myalgia's and generalized joint pain. He had previously sought medical attention and was placed on ciprofloxacin. However, he developed facial swelling and a rash and had to discontinue the antibiotic. On physical exam the patient had a large swelling and tenderness in his left periauricular area, with erythema and deviation of the right mandible which limited his ability to open the mouth. A computed tomography showed mild asymmetric soft tissue swelling in the left pharyngeal region but did not show joint effusion. Subsequent magnetic resonance imaging did show effusion of the joint space. The effusion was drained, and the synovial fluid was submitted for gram stain, culture, and sensitivity. The cultures grew menthicillin sensitive Staphyloccocus Aureus. The patient was discharged to complete a two week course of intravenous (IV) Ceftriaxone and IV Vancomycin via home infusion.

Conclusion: Septic Arthritis of the TMJ is a rare event with very specific clinical symptoms. Due to the low sensitivity of the computed tomography scan, magnetic resonance imaging should be considered when computed tomography scan is negative for TMJ effusion.

Keywords: Computed tomography; magnetic resonance imaging; septic arthritis; temporomandibular joint.

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Figures

Figure 1
Figure 1
CT of TMJ Joints. CT = Computed tomography, TMJ = Temporomandibular joint
Figure 2
Figure 2
MRI of left TMJ joint with effusion circled. MRI = Magnetic resonance imaging
See this image and copyright information in PMC

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References

    1. Goldschmidt MJ, Butterfield KJ, Goracy ES, Goldberg MH. Streptococcal infection of the temporomandibular joint of hematogenous origin: A case report and contemporary therapy. J Oral Maxillofac Surg. 2002:1347–53. - PubMed
    1. Sembronio S, Albiero AM, Robiony M, Costa F, Toro C, Politi M. Septic arthritis of the temporomandibular joint successfully treated with arthroscopic lysis and lavage: Case report and review of the literature. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007;103:e1–6. - PubMed
    1. Kim HM, Kim TW, Hwang JH, Lee DJ, Park NR, Song SI. Infection of the temporomandibular joint: A report of three cases. J Korean Assoc Oral Maxillof Surg. 2011;37:510–14.
    1. National of Dental and Craniofacial Research, TMJ Disorders. [Accessed March 24, 2015]. at http://www.nidcr.nih.gov/oralhealth/Topics/TMJ/TMJDisorders.htm .
    1. de Souza RF, Lovato da Silva CH, Nasser M, Fedorowicz Z, Al-Muharraqi MA. Interventions for the management of temporomandibular joint osteoarthritis. Cochrane Database Syst Rev. 2012;4:CD007261. - PMC - PubMed

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