経時的に下顎頭の骨変化を観察した急性化膿性顎関節炎の１例

Abstract

We describe a case of acute suppurative arthritis of the temporomandibular joint that gradually progressedto degenerative bony changes of the condyle over a period of 3 years 3months safter treatment. However, the patient remained clinically asymptomatic.The patient, a 51-year-old man, presented with trismus and severe TMJ pain. On initial examination, themandible was found to have shifted to the contralateral side, with malocculusion. The range of motion was limitedto 24mm. CT scans revealed massive swelling of the lateral pterygoid muscle. The right mandibular condylarhead was displaced anteriorly.The patient was admitted to the hospital and underwent surgical drainage from the joint space. The right maxillarymolar stumps were removed. The symptoms completely resolved within 2 weeks. The occlusion returned towithin normal limits. Maximum opening increased to 44mm. However, CT scans revealed worm-hole-like boneresorption in the right TMJ condyle. The patient was discharged from the hospital on 17th day.Follow-up was uneventful, and maximum opening increased to 52mm. CT scans disclosed extensive resorptionof the lateral condyle and proliferative bony changes of the articular surfaces. However, the patient was asymptomaticwithout further disturbance of daily activities, maintaining a range of motion of 48mm.