Otogenic temporomandibular septic arthritis in a child: a case report and a review of the literature

Abstract

Background: Acute otitis media is one of the most common infectious diseases in the paediatric age and although its complications such as acute mastoiditis have become rare thanks to improvements in therapeutic approaches, possible serious complications such as septic arthritis of the temporomandibular joint may develop. A prompt diagnosis and adequate treatment are essential to achieving the best outcome and avoiding serious sequelae. We describe a case occurring in a previously healthy 6-year-old female and review the literature currently available on this topic.

Case presentation: The patient presented a right temporomandibular septic arthritis with initial mandibular bone involvement secondary to acute otitis media. She presented with torcicollis, trismus, right preauricular swelling over the temporomandibular joint and was successfully treated with antibiotic treatment alone.

Conclusions: Septic arthritis of the temporomandibular joint is a rare complication of acute otitis media or acute mastoiditis in children. It should be suspected in patients presenting with trismus, preauricular swelling or fever. No guidelines on the diagnosis and treatment of this infectious disease are currently available.

Keywords: Acute otitis media; Children; Septic arthritis; Temporomandibular joint.

Fig. 1

a STIR coronal image performed in the acute phase shows hyperintensity of the right mandibular condyle consistent with bone oedema/inflammation and minimal effusion in the articular space, suggesting osteoarthritis. b STIR coronal image performed 1 month after discharge shows a reduction in bone hyperintensity and complete reabsorption of the effusion. c STIR coronal image performed 10 months later shows complete recovery of the normal bone intensity of the right mandibular condyle