Septic arthritis of temporomandibular joint treated with arthroscopy

Abstract

PURPOSE: To summarize the findings of imaging studies and arthroscopy in patients with septic arthritis of temporomandibular joint who were managed with arthroscopy,and to recommend the operative procedures for acute and chronic stage.METHODS: Seven patients were included in this study.Their demographics,predisposing factors,clinical manifestation,imaging findings,joint aspiration,joint fluid culture,arthroscopic findings,treatments,and outcomes were collected and analyzed.RESULTS: The common symptoms were trismus and pain.Series of imaging studies showed widening of joint space in 1 patient with plain film;MRI demonstrated increased joint effusion in 4 patients;accompanied cellulitis in adjacent tissues was discerned by CT in 2 patients;under arthroscope,the reddened and swollen synovial membrane was found in 2 patients who were in acute stage,while severe adhesions,destruction of cartilage and bony defects were discovered in other 5 patients in chronic stage.Additionally,the disc was ruptured in 3 patients,and fibrosis was confirmed for 2 patients.Lavage,lysis of adhesion and debridement of articular surface were common procedures for treatments.The average follow-up period was 57.4 months,and no recurrence was found.CONCLUSION: Arthroscopy is proved to be a useful method for management of septic arthritis of TMJ,especially for the patients in chronic stage.